Healthcare Provider Details

I. General information

NPI: 1952287773
Provider Name (Legal Business Name): AUSTIN L ERRICO, PH.D. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CUNNINGHAM RD
FREEPORT ME
04032-6312
US

IV. Provider business mailing address

45 CUNNINGHAM RD
FREEPORT ME
04032-6312
US

V. Phone/Fax

Practice location:
  • Phone: 207-809-9007
  • Fax:
Mailing address:
  • Phone: 207-809-9007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. AUSTIN L ERRICO
Title or Position: OWNER
Credential: PH. D.
Phone: 207-809-9007