Mary Alyce Burkhart, PH.D.
Individual provider Active NPI Clinical Psychologist · Hallowell, ME
NPI 1992828628 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992828628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PS762 (ME)
- Practice address
- 93 Second St
Hallowell, ME 04347-1450 - Phone
- (207) 621-1776
- Fax
- (207) 621-0692
- NPI assigned
- Apr 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS762 | ME | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Brain Clinic of Central Maine, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS762 | ME | Yes |
Addresses
Primary practice location
93 Second St
Hallowell, ME 04347-1450
Mailing address
93 Second St
Hallowell, ME 04347-1450
Phone (207) 621-1776
Other providers in Hallowell, ME
- Thomas Jeffrey Benn
- Anne Borkowski
- Caryn Alice Boutaugh
- Judy Alice Brooks
- Katherine A Brough
- Julie Burnham
- Caresync LLC
- CC Dennis Counseling Services
- Chiroworks, LLC
- Neil Brian Colan
All providers in Hallowell, ME · Clinical Psychologist in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.