Basic Information
| Provider Information | |||||||||
| NPI: | 1407058431 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHARNEY | ||||||||
| FirstName: | MEREDITH | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 MAINE ST STE 309 | ||||||||
| Address2: | |||||||||
| City: | BRUNSWICK | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040112033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177245600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22 BRAMHALL ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | ME | ||||||||
| PostalCode: | 041023134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076620111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2007 | ||||||||
| LastUpdateDate: | 01/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | NOT APPLICABLE | MA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 103T00000X | PS1566 | ME | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.