NPI 1730902891 · live from the CMS NPI Registry
Beacon Light Neuropsychology, LLC
Clinical Neuropsychologist in Portland, ME. National Provider Identifier 1730902891, active.
NPI record
| NPI | 1730902891 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinical Neuropsychologist 103G00000X |
| Practice location | 22 Free St Ste 404, Portland, ME 04101 |
| Practice phone | 207-544-6810 |
| Enumerated | November 6, 2024 |
| Last updated | November 23, 2025 |
| Authorized official | Craig Digiovanni, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | — |
| Clinical Neuropsychologist primary | 103G00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.