Carly J Rodgers, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS1555 Issued in ME

Practice address

205 Ocean Ave
Portland, ME 04103-5712

Phone

(207) 554-7906

Fax

(207) 773-5512

NPI assigned

Dec 13, 2007

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 identifiers 1

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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

• Aroostook Mental Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Presque Isle, ME
  • NPI 1487601399

  Psychologist

  NPD (past)

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1851574768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 OCEAN AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035712",
            "telephone_number": "207-554-7906",
            "fax_number": "207-773-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 OCEAN AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035712",
            "telephone_number": "207-554-7906",
            "fax_number": "207-773-5512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Edgemont Dr",
            "address_purpose": "LOCATION",
            "city": "Presque Isle",
            "state": "ME",
            "postal_code": "047692036",
            "country_code": "US",
            "telephone_number": "207-764-3319",
            "fax_number": "207-768-5377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "CARLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS1555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE CARE",
            "identifier": "103850000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Rockett, LCSW
• Rocky Coast Family Acupuncture, PA
• Carlos Rodas, DO
• Christine Roderick
• Stephanie Roderick
• Katherine Rodney
• Patricia A Rodrigue, CRNA
• Kayla Rodriguez
• Frederick Clapp Roediger, M.D.
• John H Roediger, M.D

• Psychologist in Portland, ME
• Providers in Portland, ME by specialty
• Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.