KERRY DRACH (NPI# 1063586683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063586683 |
| Entity Type | Individual |
| Full Name | KERRY DRACH |
| Credential | PHD |
| Practice Address |
17 Bishop St Portland ME 04103-2659 |
| Mailing Address |
899 Riverside St Portland ME 04103-1070 |
| Practice Telephone | 2078711235 |
| Practice Fax Number | 2078796161 |
| Mailing Telephone | 2078711200 |
| Mailing Fax Number | 2078711232 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS623 | ME | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | ANTHEM | RB8 | 01 |
| Street Address |
17 BISHOP ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103-2659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316945090 | Spurwink Services Incorporated | Case Management | 17 Bishop St, Portland, ME 04103-2659 | 2005-07-07 |
| 1376190173 | Allison Leslie Hart | Counselor | 17 Bishop St, Portland, ME 04103-2659 | 2019-08-26 |
| 1619538782 | Gabrielle Alyson Bowker | Family Medicine | 17 Bishop St, Portland, ME 04103-2659 | 2019-06-27 |
| 1316417397 | Guardian Portland LLC | Clinic/Center | 17 Bishop St, Portland, ME 04103-2659 | 2018-12-03 |
| 1730673088 | Pine Tree Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 17 Bishop St, Portland, ME 04103-2659 | 2018-06-20 |
| 1902200868 | Jamie Hussey | Social Worker | 17 Bishop St, Portland, ME 04103-2659 | 2014-10-21 |
| 1609184654 | Randi-anne Bruneau | Counselor | 17 Bishop St, Portland, ME 04103-2659 | 2010-09-23 |
| 1164730685 | Sarah Ann Labonte | Nurse Practitioner | 17 Bishop St, 2nd Floor, Portland, ME 04103-2659 | 2010-09-17 |
| 1023259892 | Rebecca W Spitko | Case Manager/Care Coordinator | 17 Bishop St, Portland, ME 04103-2659 | 2009-03-09 |
| 1487802013 | Ricque V Finucane | Counselor | 17 Bishop St, Portland, ME 04103-2659 | 2008-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007387 | Lyle Vintinner | Psychologist | 53 Baxter Blvd Ste 3, Portland, ME 04101-1827 | 2020-09-11 |
| 1194341297 | Natalie Dawn Mitchell | Psychologist | 3762 Sw Council Crest Dr, Portland, OR 97239-1595 | 2020-06-24 |
| 1992331607 | Erin A. Mueller | Psychologist | 718 Sw Alder St Ste 200, Portland, OR 97205-3423 | 2020-03-14 |
| 1952940520 | Timothy Allen Cooper | Psychologist | 3331 Sw Hamilton Ct, Portland, OR 97239-1256 | 2019-12-31 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1093373631 | Emily Catherine Stasko | Psychologist | 1950 Nw Raleigh St Apt 201, Portland, OR 97209-1775 | 2019-05-29 |
| 1174094544 | Juniper Psychological Services | Psychologist | 2827 Ne Alberta St, Portland, OR 97211-6350 | 2018-12-11 |
| 1528539335 | Mark G Kiefner Phd LLC | Psychologist | 225 Commercial St Ste 403, Portland, ME 04101-6603 | 2018-12-06 |
| 1467941831 | Shannon Madore | Psychologist | 3710 Sw Us Veterans Hospital Rd # R&d66, Portland, OR 97239-2964 | 2018-05-01 |
| 1033637202 | Kaylin Jones | Psychologist | 1235 Se Division Street, Suite 115, Portland, OR 97202-9720 | 2017-09-07 |
| Find all providers in PORTLAND | ||||
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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.