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NPI 1922187202

NPI 1922187202 : JAMES F WHELAN PSYD : SOUTH PORTLAND, ME

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General NPI Number Information
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    NPI Number           |    1922187202
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES F WHELAN PSYD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/06/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    341 PINE ST 
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    City                 |    SOUTH PORTLAND
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    State                |    ME
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    Zip                  |    04106-3842
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    Country              |    US
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    Telephone            |    207-871-1205
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    Fax                  |    207-871-1237
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Provider Business Mailing Address
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    Address Line         |    899 RIVERSIDE ST 
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    City                 |    PORTLAND
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    State                |    ME
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    Zip                  |    04103-1070
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    Country              |    US
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    Telephone            |    207-871-1200
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    Fax                  |    207-871-1232
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    PS835
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    License Number State |    ME
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Taxonomy #2
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    6996
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    License Number State |    MA
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