Kim Rosan Tousignant, PSY.D.,

Individual provider Active NPI Clinical Psychologist · Bucksport, ME

NPI 1992870976 · NPPES record last updated Nov 19, 2014

Key facts

NPI
1992870976
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PS1257 (ME)
Practice address
151 Main Street
Suite 2
Bucksport, ME 04416
Phone
(207) 460-7974
Fax
(207) 469-1932
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

151 Main St
Bucksport, ME 04416-4076
Phone (207) 944-8881

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130913000328 ME Practitioner - Clinical Psychologist 1850535808 Practice locations: Bucksport, ME

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS1257 ME Yes

Addresses

Primary practice location

151 Main Street
Suite 2
Bucksport, ME 04416

Mailing address

PO Box 1694
Bucksport, ME 04416-1694
Phone (207) 460-7974

Other identifiers

IdentifierTypeStateIssuer
283850000MedicaidME
003401401OtherMEMEDICARE PTAN
047415OtherMEANTHEM
7118205OtherMEAETNA

Other providers in Bucksport, ME

All providers in Bucksport, ME · Clinical Psychologist in Maine

Sources for this page

Verify at the official NPI Registry.