Provider Demographics
NPI:1326571241
Name:PSYCHOLOGY SPECIALISTS OF MAINE
Entity Type:Organization
Organization Name:PSYCHOLOGY SPECIALISTS OF MAINE
Other - Org Name:JULIE L. QUIMBY, PH.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:QUIMBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:207-607-4022
Mailing Address - Street 1:14 MAINE ST.
Mailing Address - Street 2:BOX 65
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011
Mailing Address - Country:US
Mailing Address - Phone:207-607-4022
Mailing Address - Fax:207-607-4048
Practice Address - Street 1:14 MAINE ST.
Practice Address - Street 2:SUITE 309
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011
Practice Address - Country:US
Practice Address - Phone:207-607-4022
Practice Address - Fax:207-607-4048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1256103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty