Beacon Light Neuropsychology, LLC
Clinical Neuropsychologist in Portland, ME. Organization (NPI-2).
NPI number1730902891
StatusActive
Last updated in NPPESNov 23, 2025
Details
- NPI
- 1730902891
- Entity type
- Organization (NPI-2)
- Legal business name
- Beacon Light Neuropsychology, LLC
- Organization subpart
- No
- Enumeration date
- Nov 6, 2024
- Certification date
- Nov 23, 2025
- Last updated
- Nov 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | – | – | Yes |
| 103K00000X | Behavior Analyst | – | – |
Practice location
22 Free St Ste 404Portland, ME 04101-3900
Phone 207-544-6810 · Fax 207-544-6888
Mailing address
22 Free St Ste 404Portland, ME 04101-3900
Phone 207-544-6810 · Fax 207-544-6888
Authorized official
Craig Digiovanni
Owner
8609658054
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