MEDICARE: DR. CARLANN M WELCH PSY.D.

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	103T00000X	Psychologist	PS847	ME
2	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	CNP191213	ME
3	364SP0807X	Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist	CNP191213	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063554947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLANN M WELCH PSY.D.

Provider Business Mailing Address
First Line	:	57 EXCHANGE ST
Second Line	:	SUITE 403
City	:	PORTLAND
State	:	ME
Zip	:	04101-5000
Country	:	US
Telephone Number	:	207-775-0382
Fax Number	:	207-775-4454

Provider Business Practice Location Address
First Line	:	57 EXCHANGE ST
Second Line	:	SUITE 403
City	:	PORTLAND
State	:	ME
Zip	:	04101-5000
Country	:	US
Telephone Number	:	207-775-0382
Fax Number	:	207-775-4454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	04/11/2025

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