Provider Demographics
NPI:1558347385
Name:INGERSON, SYLVIA IRENE (PMH-N, CNS)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:IRENE
Last Name:INGERSON
Suffix:
Gender:F
Credentials:PMH-N, CNS
Other - Prefix:MISS
Other - First Name:SYLVIA
Other - Middle Name:IRENE
Other - Last Name:LEVASSEUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMH NP CNS LADC
Mailing Address - Street 1:213 TITCOMB HILL RD 4B
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-5639
Mailing Address - Country:US
Mailing Address - Phone:207-778-1862
Mailing Address - Fax:
Practice Address - Street 1:213 TITCOMB HILL RD
Practice Address - Street 2:UNIT B4
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-5639
Practice Address - Country:US
Practice Address - Phone:207-288-8604
Practice Address - Fax:207-288-8602
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81144363LP0808X
MERO14261363LP0808X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0NS8053Medicaid
VT2082154OtherCIGNA BEHAVIORAL HEALTH
ME432710499Medicaid
VT68944BSOtherBLUE SHIELD OF VT
P42575Medicare UPIN
NP5185Medicare PIN
ME000284602Medicare PIN
VT2082154OtherCIGNA BEHAVIORAL HEALTH
VT0NS8053Medicaid