1306907811 NPI number — MRS. MARGARET KATHLEEN BERMINGHAM MA

Table of content: MRS. MARGARET KATHLEEN BERMINGHAM MA (NPI 1306907811)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306907811 NPI number — MRS. MARGARET KATHLEEN BERMINGHAM MA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERMINGHAM
Provider First Name:
MARGARET
Provider Middle Name:
KATHLEEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FENNELL
Provider Other First Name:
MAGGIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306907811
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8274 MAYFLOWER HL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WATERVILLE
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04901-8881
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-692-4082
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
67 EUSTIS PKWY
Provider Second Line Business Practice Location Address:
KENNEBEC BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
WATERVILLE
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04901-5173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-873-2136
Provider Business Practice Location Address Fax Number:
207-872-4522
Provider Enumeration Date:
12/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  T0398 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: MF4022 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com