Provider Demographics
NPI:1386978849
Name:STANARD MARANCIK, PIA MICHELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:PIA
Middle Name:MICHELLE
Last Name:STANARD MARANCIK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:PIA
Other - Middle Name:MICHELLE
Other - Last Name:STANARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:899 RIVERSIDE STREET
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103
Mailing Address - Country:US
Mailing Address - Phone:207-871-1200
Mailing Address - Fax:207-871-1232
Practice Address - Street 1:31 SPURWINK DR
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:ME
Practice Address - Zip Code:04330-1166
Practice Address - Country:US
Practice Address - Phone:207-582-7686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD04887103T00000X
MEXL3856101YP2500X
MEPS1389103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional