Provider Demographics
NPI:1285842708
Name:KINAST, CECILIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:
Last Name:KINAST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BEACON STREET
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843
Mailing Address - Country:US
Mailing Address - Phone:207-236-3083
Mailing Address - Fax:207-236-3083
Practice Address - Street 1:21 ELM ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1949
Practice Address - Country:US
Practice Address - Phone:207-236-3083
Practice Address - Fax:207-236-3083
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS003473103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist