Annie Derthick, PHD | |
76 High St, Lewiston, ME 04240 | |
(207) 795-2800 | |
Not Available |
Full Name | Annie Derthick |
---|---|
Gender | Female |
Speciality | Psychologist - Family |
Location | 76 High St, Lewiston, Maine |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689039422 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 107779 (Alaska) | Secondary |
103TF0000X | Psychologist - Family | PS1563 (Maine) | Primary |
Entity Name | Central Maine Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689653487 PECOS PAC ID: 2567379563 Enrollment ID: O20040324000441 |
Mailing Address | Practice Location Address |
---|---|
Annie Derthick, PHD 76 High St, Lewiston, ME 04240-7649 Ph: (207) 795-2800 | Annie Derthick, PHD 76 High St, Lewiston, ME 04240 Ph: (207) 795-2800 |
Frank Ellis, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 111 Pond Rd, Lewiston, ME 04240 Phone: 207-784-0697 | |
George R Sheckart, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 33r Mollison Way, Lewiston, ME 04240 Phone: 207-755-3785 Fax: 207-376-3080 | |
Kathia Djoumou Sow, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 51 Bridge St, Lewiston, ME 04240 Phone: 207-415-3863 | |
Jean Pierre N/a Akayezu, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4 School St, Lewiston, ME 04240 Phone: 207-409-9804 | |
James Cogan, PH.D Psychologist Medicare: Medicare Enrolled Practice Location: 443 Main St, Lewiston, ME 04240 Phone: 207-576-6423 Fax: 207-783-1880 | |
Mr. Ira J Rosen, PH D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 443 Main St, Lewiston, ME 04240 Phone: 207-786-0270 Fax: 207-783-0500 | |
Dr. David Scott Austin, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 15 Challenger Dr, Lewiston, ME 04240 Phone: 207-623-8411 |