# JONATHAN C FELLERS MD PA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cortex Behavioral Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457823817
- **Authorized official:** JONATHAN CARL FELLERS MD (OWNER)
- **Authorized official phone:** (207) 221-0635

## Contact information

- **Practice address:** 1 CITY CTR STE 8130, PORTLAND, ME 04101-6420
- **Practice address phone:** (207) 221-0635
- **Practice address fax:** (207) 221-0634
- **Mailing address:** 1 CITY CTR STE 8130, PORTLAND, ME 04101-6420
- **Mailing address phone:** (207) 221-0635
- **Mailing address fax:** (207) 221-0634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 202C00000X | Independent Medical Examiner Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 2084P0802X | Addiction Psychiatry Physician | — | NULL | — |
| 2084P0802X | Addiction Psychiatry Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/26/2018
- **Last updated:** 08/22/2025