Kimberly A Landrau, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS2443 Issued in ME

Practice address

40 Devereux Road
Perry, ME 04667

Phone

(207) 904-7589

NPI assigned

Jan 29, 2019

Last updated

Jan 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Counseling Center of Nashua IncGroup PAC ID 3274523758, 250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/luk/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Counseling Center of Nashua Inc

  dba LifeStance Health

  • Clinical Psychologist
  • Nashua, NH
  • NPI 1144275389

  ME

  Medicare reassignment Care Compare group NPD
• Luk Crisis Center Inc.

  • Community/Behavioral Health Agency
  • Fitchburg, MA
  • NPI 1306962741
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1720542202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 DEVEREUX ROAD",
            "city": "PERRY",
            "state": "ME",
            "postal_code": "04667",
            "telephone_number": "207-904-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DEVEREUX ROAD",
            "city": "PERRY",
            "state": "ME",
            "postal_code": "04667",
            "telephone_number": "207-904-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRAU",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS2443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susanne Carroll Duffy, PSYD
• Cedar Haven Counseling, LLC
• Faith Cummings, CNA
• Cyrilla M Francis
• Edward F. Harris, DMD
• Passamaquoddy Tribal Council (Sipayik Ambulance Service)
• Perry Elementary School
• Ronald S Rosenfeld, M.D.
• Sue Carroll Duffy, Psy.D., LLC Susanne Carroll Duffy Sole MBR (Moving Stories)
• Batya Zamir-Vanburen, LCSW

• Clinical Psychologist in Perry, ME
• Providers in Perry, ME by specialty
• Clinical Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.