| Fran Rodenburg, Ph.d., Ladc,llc | |
|
585 Forest Ave Portland ME 04101-1519 | |
| (207) 239-2356 | |
| Not Available |
| Full Name | Fran Rodenburg, Ph.d., Ladc,llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 585 Forest Ave, Portland, Maine |
| Authorized Official Name and Position | Fran Ann Rodenburg (OWNER) |
| Authorized Official Contact | 2072392356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fran Rodenburg, Ph.d., Ladc,llc 14 Kelley Way Westbrook ME 04092-2762 Ph: (207) 239-2356 | Fran Rodenburg, Ph.d., Ladc,llc 585 Forest Ave Portland ME 04101-1519 Ph: (207) 239-2356 |
| NPI Number | 1568249829 |
|---|---|
| Provider Enumeration Date | 09/11/2023 |
| Last Update Date | 03/15/2024 |
| Certification Date | 03/15/2024 |
| Medicare PECOS PAC ID | 1355787409 |
|---|---|
| Medicare Enrollment ID | O20240311003695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568249829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Frances Rodenburg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376165274 PECOS PAC ID: 9436553203 Enrollment ID: I20210802003217 |
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