| Sound Mind Psychology LLC | |
|
110 Main St Ste 1201b Saco ME 04072-3516 | |
| (207) 229-2747 | |
| (207) 517-5078 |
| Full Name | Sound Mind Psychology LLC |
|---|---|
| Speciality | Psychologist |
| Location | 110 Main St Ste 1201b, Saco, Maine |
| Authorized Official Name and Position | Christopher Johnson (OWNER) |
| Authorized Official Contact | 2072292747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sound Mind Psychology LLC 110 Main St Ste 1201b Saco ME 04072-3516 Ph: (207) 229-2747 | Sound Mind Psychology LLC 110 Main St Ste 1201b Saco ME 04072-3516 Ph: (207) 229-2747 |
| NPI Number | 1720696586 |
|---|---|
| Provider Enumeration Date | 07/17/2020 |
| Last Update Date | 10/15/2020 |
| Certification Date | 10/15/2020 |
| Medicare PECOS PAC ID | 1355760737 |
|---|---|
| Medicare Enrollment ID | O20201005001140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720696586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | () | Primary |
| Provider Name | Christopher Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205454741 PECOS PAC ID: 6800215286 Enrollment ID: I20201005001341 |
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