LARISSA ARAXE MEAD-WESCOTT (NPI# 1417922725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417922725 |
| Entity Type | Individual |
| Full Name | LARISSA ARAXE MEAD-WESCOTT |
| Other Name | LARISSA ARAXE MEAD |
| Credential | PHD |
| Practice Address |
277 State St Suite 2a Bangor ME 04401-5439 |
| Practice Telephone | 2079902580 |
| Practice Fax Number | 2079901930 |
| Mailing Telephone | 2079902580 |
| Mailing Fax Number | 2079901930 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2010-11-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PS960 | ME | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 3069401 | 01 | |
| ANTHEM | 036895 | 01 | |
| ME | 330640099 | 05 |
| Street Address |
277 STATE ST SUITE 2A |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-5439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556652 | Edwin Jay Bruno | Podiatrist | 277 State St, Ste 1b, Bangor, ME 04401-5440 | 2005-05-23 |
| 1427503192 | Martina Pauline Bosse | Physical Therapist | 277 State St, Bangor, ME 04401-5439 | 2016-08-23 |
| 1215333554 | Performance Physical Therapy and Sports Rehab Inc. | Physical Therapist | 277 State St, Suite 1b, Bangor, ME 04401-5439 | 2014-11-14 |
| 1922328194 | Travis Raymond Buxton | Dentist | 277 State St, Suite 2b, Bangor, ME 04401-5439 | 2010-06-10 |
| 1689891384 | Lola C. Bogyo | Clinical Neuropsychologist | 277 State St, Suite 2a, Bangor, ME 04401-5439 | 2007-04-20 |
| 1760512446 | Maine Family Dental Practice Pa | Dentist | 277 State St, Suite 2b, Bangor, ME 04401 | 2007-03-06 |
| 1174635197 | Scott E Mcgarr | Dentist | 277 State St, Suite 2b, Bangor, ME 04401 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255492716 | Robert L. Gallon | Clinical Neuropsychologist | 77 James St, Bangor, ME 04401-4661 | 2006-12-12 |
| 1437197001 | Anthony Podraza | Clinical Neuropsychologist | 905 Union St, Suite 9, Bangor, ME 04401-3050 | 2006-06-03 |
| 1598703175 | Bonnie Creech | Clinical Neuropsychologist | 905 Union St Ste 9, Bangor, ME 04401-3039 | 2006-06-03 |
| 1790765329 | Christine Mary Fink | Clinical Neuropsychologist | 417 State Street, Webber East, Suite 209, Bangor, ME 04401 | 2006-01-19 |
| 1437138765 | Royal Gene Grueneich | Clinical Neuropsychologist | 277 State Street, Ste 2a, Bangor, ME 04401-5440 | 2006-01-13 |
| 1689891384 | Lola C. Bogyo | Clinical Neuropsychologist | 277 State St, Suite 2a, Bangor, ME 04401-5439 | 2007-04-20 |
| 1164465696 | James Thomas | Clinical Neuropsychologist | 489 State St, Bangor, ME 04401-6616 | 2006-06-13 |
| 1396783973 | Dorothy Strom | Clinical Neuropsychologist | 824 Stillwater Ave, Suite B, Bangor, ME 04401-3614 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467909168 | Maureen D. Sanford | Clinical Neuropsychologist | 120 Main St Ste 126, Saco, ME 04072-3527 | 2016-09-10 |
| 1033666359 | Rebecca Richards | Clinical Neuropsychologist | 2178 Post Rd Ste 201, Wells, ME 04090-4794 | 2016-09-02 |
| 1033592837 | Rachel Lawson Orr | Clinical Neuropsychologist | Southern Maine Health Care Pediatrics, 3 Shape Drive, Kennebunk, ME 04043 | 2015-06-30 |
| 1326451212 | Abigail Bernett Ryan | Clinical Neuropsychologist | 220 Union St, Rockport, ME 04856 | 2014-06-09 |
| 1770788598 | Austin Louis Errico | Clinical Neuropsychologist | 45 Cunningham Rd, Freeport, ME 04032-6312 | 2007-06-20 |
| 1346457017 | Mark Gregory Kiefner | Clinical Neuropsychologist | 26 Portland Street, Portland, ME 04101 | 2007-05-16 |
| 1184774937 | Melvyn E Attfield | Clinical Neuropsychologist | 225 Commercial Street, Suite #303, Portland, ME 04101 | 2007-01-12 |
| 1174685945 | Christine Barth Ramsay | Clinical Neuropsychologist | 21 Bailey Farm Rd, Freeport, ME 04032-5808 | 2006-12-15 |
| 1821150699 | David A Marks | Clinical Neuropsychologist | 500 Route 1 Ste 26, Yarmouth, ME 04096-4712 | 2006-12-15 |
| 1386706802 | Howard R Kessler | Clinical Neuropsychologist | 500 Us Route 1 Ste 26, Yarmouth, ME 04096 | 2006-12-14 |
| Find all providers with the same taxonomy | ||||
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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.