Provider Demographics
NPI:1710403571
Name:NEUROCONNECTIONS, LLC
Entity Type:Organization
Organization Name:NEUROCONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:207-352-5011
Mailing Address - Street 1:120 MAIN ST STE 126
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-3527
Mailing Address - Country:US
Mailing Address - Phone:207-352-5011
Mailing Address - Fax:207-352-5013
Practice Address - Street 1:120 MAIN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3527
Practice Address - Country:US
Practice Address - Phone:207-289-0466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME103G00000X, 103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty