Provider Demographics
NPI:1750466959
Name:SONNET PSYCHOLOGICAL, LLC
Entity Type:Organization
Organization Name:SONNET PSYCHOLOGICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:LILLY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:207-865-9692
Mailing Address - Street 1:174 S FREEPORT RD
Mailing Address - Street 2:2E
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032
Mailing Address - Country:US
Mailing Address - Phone:207-865-9225
Mailing Address - Fax:207-865-9241
Practice Address - Street 1:174 S FREEPORT RD
Practice Address - Street 2:2E
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032
Practice Address - Country:US
Practice Address - Phone:207-865-9225
Practice Address - Fax:207-865-9241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty