Provider Demographics
NPI:1285931022
Name:CATHERINE A. SPEDDEN, PSYD, LLC
Entity type:Organization
Organization Name:CATHERINE A. SPEDDEN, PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPEDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:207-553-0312
Mailing Address - Street 1:225 COMMERCIAL ST
Mailing Address - Street 2:SUITE 401B
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4613
Mailing Address - Country:US
Mailing Address - Phone:207-553-0312
Mailing Address - Fax:
Practice Address - Street 1:225 COMMERCIAL ST
Practice Address - Street 2:SUITE 401B
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4613
Practice Address - Country:US
Practice Address - Phone:207-553-0312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1088103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME039601Medicare PIN