Provider Demographics
NPI:1053206730
Name:NEW ENGLAND PSYCHIATRIC PLLC
Entity type:Organization
Organization Name:NEW ENGLAND PSYCHIATRIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-600-5339
Mailing Address - Street 1:415 CONGRESS ST STE 202A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3500
Mailing Address - Country:US
Mailing Address - Phone:207-600-5339
Mailing Address - Fax:
Practice Address - Street 1:415 CONGRESS ST STE 202A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3500
Practice Address - Country:US
Practice Address - Phone:207-600-5339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)