| Foreside Behavior Associates | |
|
1321 Washington Ave Ste 302 Portland ME 04103-3675 | |
| (207) 613-7324 | |
| (207) 613-7333 |
| Full Name | Foreside Behavior Associates |
|---|---|
| Speciality | Psychologist |
| Location | 1321 Washington Ave Ste 302, Portland, Maine |
| Authorized Official Name and Position | Susan Jarmuz-smith (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2076137324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foreside Behavior Associates 1321 Washington Ave Ste 302 Portland ME 04103-3675 Ph: (207) 613-7324 | Foreside Behavior Associates 1321 Washington Ave Ste 302 Portland ME 04103-3675 Ph: (207) 613-7324 |
| NPI Number | 1982076485 |
|---|---|
| Provider Enumeration Date | 10/22/2015 |
| Last Update Date | 11/23/2022 |
| Certification Date | 11/23/2022 |
| Medicare PECOS PAC ID | 0941581664 |
|---|---|
| Medicare Enrollment ID | O20170206000593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982076485 | NPI | - | NPPES |
| 1164824082 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan Lynn Jarmuz-smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164824082 PECOS PAC ID: 3678854395 Enrollment ID: I20170206000720 |
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