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Individual

DR. JAMES MCELLIGOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
53 BAXTER BLVD, PORTLAND, ME 04101-1827
(207) 774-8700
Mailing address
53 BAXTER BLVD STE 3, PORTLAND, ME 04101-1827
(207) 774-8700

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
103TC0700X
Clinical Psychologist
05949
MD
103TC0700X
Clinical Psychologist
Primary
PS1573
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1205210127
DE
05
1205210127
MD
05
1205210127
ME
Enumeration date
07/10/2015
Last updated
08/23/2024
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