Unknown Individual – Psychiatry Physician, NPI 1124085741
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
78, Atlantic Place, South Portland, Cumberland County, Maine, 04106, United States
SOUTH PORTLAND, ME 041062316
Phone: (207) 842-6556
Fax: (207) 842-7773
Type: Mailing
Maine Behavioral Healthcare, 12, Union Street, Rockland, Knox County, Maine, 04841, United States
ROCKLAND, ME 048412739
Phone: (207) 701-4402
Fax: (207) 701-4486
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2023-02-24 • Largest payer in this snapshot: ABBVIE INC. ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $16 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 04106)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | ME | 90833 | Psychotherapy, 30 minutes with patient and/or family member | 60 | 25 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TN | |
| P S Y C H I A T R Y | TN | |
| P S Y C H I A T R Y | AR | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| Clinical Psychologist | TN |
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