Alisa Renee Wing, MA/CAS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

459729 Issued in ME

Practice address

28A Main Road South
Hampden, ME 04444

Phone

(207) 862-2774

NPI assigned

Jun 23, 2014

Last updated

Jun 23, 2014By 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 1

Addresses

Other names 1

• Alisa Renee Makson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1841605557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 RUGOSA LN",
            "city": "LEVANT",
            "state": "ME",
            "postal_code": "044564459",
            "telephone_number": "207-631-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28A MAIN ROAD SOUTH",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "04444",
            "telephone_number": "207-862-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WING",
        "first_name": "ALISA",
        "middle_name": "RENEE",
        "credential": "MA/CAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "ME",
            "license": "459729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISA",
            "last_name": "MAKSON",
            "middle_name": "RENEE",
            "credential": "MA/CAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alissa A Wade, RDH
• Walgreen Eastern Co Inc (Walgreens #18112)
• Madeline Christina West, CCC-SLP
• Kate Weymouth, D.C
• Elizabeth White, SLP-A
• Nancy Marie Workman, M.A., SLP-CCC

• School Psychologist in Hampden, ME
• Providers in Hampden, ME by specialty
• School Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.