MEDICARE: SWELL NEUROPSYCHOLOGY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1780536227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWELL NEUROPSYCHOLOGY, LLC

Provider Business Mailing Address
First Line	:	188 STATE ST STE 407
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04101-5157
Country	:	US
Telephone Number	:	207-977-4321
Fax Number	:

Provider Business Practice Location Address
First Line	:	188 STATE ST STE 407
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04101-5157
Country	:	US
Telephone Number	:	207-977-4321
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CARLY LAUREN CLARK
Credential	:	PSYD
Telephone Number	:	207-977-4321

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

Similar Medicare Providers

1972321214 — CARLY CLARK PSYD
Practice Location Address:

188 STATE ST STE 407
PORTLAND, ME
04101-5157

Practice Phone: 207-977-4321
Practice Fax:

1083412282 — NATHALIE MBUYI
Practice Location Address:

188 STATE ST STE 402
PORTLAND, ME
04101-5157

Practice Phone: 207-321-8905
Practice Fax:

1306713243 — INCLUSIVE MINDS FOUNDATION CO.
Practice Location Address:

254 COMMERCIAL ST STE 245B
PORTLAND, ME
04101-4664

Practice Phone: 929-564-3880
Practice Fax:

1881701670 — DR. DAVID E SCHENK MD
Practice Location Address:

165 LANCASTER ST
PORTLAND, ME
04101-2406

Practice Phone: 207-661-3500
Practice Fax: 207-661-3555

1437227378 — TIFFANY P SEGRE MD
Practice Location Address:

272 CONGRESS ST
PORTLAND, ME
04101-3637

Practice Phone: 207-874-2466
Practice Fax: 207-774-4625

1588613608 — DR. CAITLIN M. MORRISROE DC
Practice Location Address:

1 CITY CTR
PORTLAND, ME
04101-6420

Practice Phone: 207-699-2622
Practice Fax:

Directions to “SWELL NEUROPSYCHOLOGY, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.