Fern River Psychiatry, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

FERN RIVER PSYCHIATRY, LLC

Practice address

50 Market Street
Ste 1a , #320
S. Portland, ME 04106-3646

Phone

(207) 956-0050

Fax

(833) 606-1216

NPI assigned

Oct 30, 2020

Last updated

Oct 4, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Abigail Keenan, DONPI 1598051989

Title

Psychiatrist

Phone

(207) 956-0050

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Abigail Keenan, DO

  • Psychiatry Physician
  • Westbrook, ME
  • NPI 1598051989
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1538769203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MARKET STREET",
            "address_2": "STE 1A, # 320",
            "city": "S. PORTLAND",
            "state": "ME",
            "postal_code": "041063646",
            "telephone_number": "207-956-0050",
            "fax_number": "833-606-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MARKET STREET",
            "address_2": "STE 1A , #320",
            "city": "S. PORTLAND",
            "state": "ME",
            "postal_code": "041063646",
            "telephone_number": "207-956-0050",
            "fax_number": "833-606-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERN RIVER PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-30",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "KEENAN",
        "authorized_official_first_name": "ABIGAIL",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "207-956-0050",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in S Portland, ME
• Providers in S Portland, ME by specialty
• Adult Mental Health Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.