Individual provider Active NPI

Kristen Anne Woodberry, PHD

  • Psychologist
  • Portland, ME
National Provider Identifier
1922279827
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS1540 Issued in ME
Practice address
66 Bramhall St
Portland, ME 04102-3344
Phone
(207) 662-2221
Fax
(207) 662-6348
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS1540 ME Primary

Addresses

Primary practice location

66 Bramhall St
Portland, ME 04102-3344

Mailing address

66 Bramhall St
Portland, ME 04102-3344
Phone (207) 662-2221

Other practice location 1

216 Vaughan St
Portland, ME 04102-3204
Phone (207) 662-2221

Other identifiers 1

IdentifierTypeStateIssuer
70010000P08174OtherMABCBSMA PROVIDER LEGACY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Two Brattle Center, P.C. Psychologist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1922279827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023344",
            "telephone_number": "207-662-2221",
            "fax_number": "207-662-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023344",
            "telephone_number": "207-662-2221",
            "fax_number": "207-662-6348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Vaughan St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023204",
            "country_code": "US",
            "telephone_number": "207-662-2221",
            "fax_number": "207-810-2367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODBERRY",
        "first_name": "KRISTEN",
        "middle_name": "ANNE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS1540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA PROVIDER LEGACY",
            "identifier": "70010000P08174",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.