DR. ANITA LAURETTE GOLLER (NPI# 1053391367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053391367 |
| Entity Type | Individual |
| Full Name | DR. ANITA LAURETTE GOLLER |
| Credential | PH.D. |
| Practice Address |
6 Cumberland St Brunswick ME 04011-1904 |
| Practice Telephone | 2077293092 |
| Mailing Telephone | 2077293092 |
| Mailing Fax Number | 2077293092 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2018-10-24 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS904 | ME | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | AETNA PIN | 7160216 | 01 |
| ME | ANTHEM BCBS PIN | 038660 | 01 |
| ME | 209210000 | 05 |
| Street Address |
6 CUMBERLAND ST |
| City | BRUNSWICK |
| State | ME |
| Zip Code | 04011-1904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609336544 | Kelly Katherine Bumiller | Counselor | 6 Cumberland St, Brunswick, ME 04011-1904 | 2019-03-25 |
| 1578956074 | Moreen Halmo | Psychologist | 6 Cumberland St, Brunswick, ME 04011-1904 | 2015-03-09 |
| 1063843431 | Charles Sifton | Acupuncturist | 6 Cumberland St, Brunswick, ME 04011-1904 | 2013-12-10 |
| 1467739433 | Amy B. Sellers | Social Worker | 6 Cumberland St, Brunswick, ME 04011-1904 | 2011-11-04 |
| 1386724391 | Whitney Houghton | Psychiatry & Neurology | 6 Cumberland St, Brunswick, ME 04011 | 2006-10-16 |
| 1326000696 | Deborah Rae Como-kepler | Counselor | 6 Cumberland St, Brunswick, ME 04011-1904 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093276370 | Convenientmd LLC | Clinic/Center | 193 Bath Road, Brunswick, ME 04011 | 2019-03-28 |
| 1326571241 | Psychology Specialists of Maine | Psychologist | 14 Maine St., Suite 309, Brunswick, ME 04011 | 2017-04-07 |
| 1992249775 | Avita Brunswick LLC | Alzheimer Center (Dementia Center) | 89 Admiral Fitch Way, Brunswick, ME 04011 | 2016-12-13 |
| 1215303433 | Mary K Kunhardt | Social Worker | 116 Maquoit Rd, Brunswick, ME 04011 | 2015-08-12 |
| 1861803843 | Gretchen Jane Stevens | Counselor | 136 Maine Street, Suite #6, Brunswick, ME 04011 | 2014-05-13 |
| 1356764567 | Kid Function, Inc. | Clinic/Center | 225 Thomas Point Road, Brunswick, ME 04011 | 2014-01-23 |
| 1356788921 | Jacques M. Reynolds | Psychiatry & Neurology | 81 Medical Center Dr # 2400, Brunswick, ME 04011 | 2013-05-23 |
| 1922369891 | Charles Russell Thorp | Pharmacist | 147 Bath Rd, Rtes 1 and 24, Merry Meeting Plaza, Brunswick, ME 04011 | 2012-06-06 |
| 1992076111 | Benjamin C. Tyau | Physician Assistant | 193 Bath Rd, Brunswick, ME 04011 | 2012-01-19 |
| 1841575339 | Bluesage Therapies Inc. | Social Worker | 214 Raymond Road, Brunswick, ME 04011 | 2011-10-15 |
| Find all providers in zip 04011 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952942559 | Andrea J Medaris | Psychologist | 153 Park Row Ste 302, Brunswick, ME 04011-2053 | 2019-10-04 |
| 1548770332 | Amanda Seirup | Psychologist | 16 Lincoln St Ste C, Brunswick, ME 04011-1900 | 2017-10-05 |
| 1346601218 | Susanna Preziosi | Psychologist | 14 Maine St Ste 309, Brunswick, ME 04011-2033 | 2016-03-18 |
| 1083914881 | South Georgia Psychological Services PC | Psychologist | 104 Dunkirk Ln, Brunswick, GA 31523-6379 | 2010-10-26 |
| 1124296231 | Discovering Choices, Inc. | Psychologist | 51 Harpswell Rd, Suite 103, Brunswick, ME 04011-2549 | 2008-02-12 |
| 1629125273 | George Steffian | Psychologist | Fasotragrulant, Detachment Brunswick, 1801 Burbank Ave, Brunswick, ME 04011 | 2007-01-05 |
| 1760577092 | William R Johnson | Psychologist | 1421 Lee Street, Brunswick, GA 31520 | 2006-10-03 |
| 1316972797 | David C Bellows | Psychologist | 240 Maine St, Brunswick, ME 04011-3365 | 2006-07-12 |
| 1790219921 | Michelle Kanga | Psychologist | 14 Maine St, Suite 309, Brunswick, ME 04011-2049 | 2017-04-14 |
| 1700320397 | Erin Sheets | Psychologist | 14 Maine St Ste 309, Brunswick, ME 04011-2052 | 2016-12-15 |
| Find all providers in BRUNSWICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.