=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376177386
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE MIND CENTER, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2020
-----------------------------------------------------
Last Update Date | 06/10/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13 RAILROAD SQ
-----------------------------------------------------
City | WATERVILLE
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04901-6139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-200-4548
-----------------------------------------------------
Fax | 207-692-1210
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 646
-----------------------------------------------------
City | OAKLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04963-0646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-200-4548
-----------------------------------------------------
Fax | 207-692-1210
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | DR. OZGUR TURKOGLU
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 207-200-4548
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------