FREDRIC A KRISTAL (NPI# 1649210865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649210865 |
| Entity Type | Individual |
| Full Name | FREDRIC A KRISTAL |
| Credential | PHD |
| Practice Address |
29 Franklin St Bangor ME 04401-4909 |
| Practice Telephone | 2079423816 |
| Practice Fax Number | 2075614725 |
| Mailing Telephone | 2079423816 |
| Mailing Fax Number | 2075614725 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PS925 | ME | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | ANTHEM LEGACY NUMBER | 098303 | 01 |
| Street Address |
29 FRANKLIN ST |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-4909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427002138 | Northeast Occupational Exchange, Inc | Psychologist | 29 Franklin St, Bangor, ME 04401-4909 | 2006-05-19 |
| 1255873154 | William Carter | Counselor | 29 Franklin St, Bangor, ME 04401-4909 | 2016-11-08 |
| 1073963427 | Joyce Dee Warren | Counselor | 29 Franklin St, Bangor, ME 04401-4909 | 2016-06-16 |
| 1588087696 | Kimberly Flanders | Counselor | 29 Franklin St, Bangor, ME 04401-4909 | 2014-01-24 |
| 1295037158 | Tammy Mccue | Counselor | 29 Franklin St, Bangor, ME 04401-4909 | 2010-11-29 |
| 1346542206 | Kate M Flanders | Counselor | 29 Franklin St, Bangor, ME 04401-4909 | 2010-11-29 |
| 1720380678 | Stephanie N Bernier | Counselor | 29 Franklin St, Bangor, ME 04401-4909 | 2010-11-29 |
| 1982930111 | Amy Louise Wescott | Social Worker | 29 Franklin St, Bangor, ME 04401-4909 | 2009-10-22 |
| 1427384817 | Leah C Isaacson | Counselor | 29 Franklin St, Bangor, ME 04401-4909 | 2009-10-20 |
| 1104080381 | Alison Lynn Glanville | Psychologist | 29 Franklin St, Bangor, ME 04401-4909 | 2008-07-16 |
| Find all providers in the same location | ||||
| 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 | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003319583 | Robert Peddicord Phd Group | Psychologist | 200 Grove St, Bangor, ME 04401-4008 | 2018-03-12 |
| 1568919132 | Bryan Safranski | Psychologist | 34276 52nd Street, Bangor, MI 49013-0177 | 2016-09-01 |
| 1245437029 | Norman Otto Worgull | Psychologist | 115 Franklin St Ste 1a, Bangor, ME 04401-4973 | 2007-06-27 |
| 1902941396 | Allies, Inc. | Psychologist | 21 Main St Ste 301, Bangor, ME 04401-6359 | 2007-02-21 |
| 1043350663 | Cheryl S Pelletier | Psychologist | 232 Seventh St, Bangor, ME 04401 | 2007-02-07 |
| 1215081930 | Michael Axelrod | Psychologist | 268 Sillwater Avenue, Acadia Hospital Corp., Bangor, ME 04401 | 2007-01-22 |
| 1184729451 | Vernon Trip A Gardner IIi | Psychologist | 181 Corporate Dr, Bangor, ME 04401-4314 | 2006-09-13 |
| 1013021187 | Beth A Bohnet | Psychologist | 51 Grove St, Bangor, ME 04401-5309 | 2006-08-18 |
| 1437168994 | Paul Franklin Pusey | Psychologist | 451 Union St, Bangor, ME 04401-4507 | 2006-08-05 |
| 1154330835 | Chrysalis Psychological Services | Psychologist | 323 W Broadway, Bangor, ME 04401-5872 | 2006-08-05 |
| Find all providers in BANGOR | ||||
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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.