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Organization
PSYCHMAINE LLC
Active
Organization
PSYCHMAINE LLC
Active
Other names
PsychMaine
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN C FELLERS MD (PSYCHIATRIST)
(207) 221-0635
Entity
Organization
Contact information
Practice address
550 FOREST AVE STE 103, PORTLAND, ME 04101-1505
(207) 221-0635
(207) 221-0634
Mailing address
550 FOREST AVE STE 103, PORTLAND, ME 04101-1505
(207) 221-0635
(207) 221-0634
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
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
Primary
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/11/2023
Last updated
03/01/2023
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