Portland Psychiatric Services, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PORTLAND PSYCHIATRIC SERVICES, LLC

Practice address

225 Commercial St Ste 300
Portland, ME 04101-6606

Phone

(207) 470-0569

NPI assigned

Dec 29, 2020

Organization subpart

No

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

Authorized official

Name

Gloria Weiss, PMHNP

Title

Owner

Phone

(207) 550-2162

Specialties & licenses 1

Addresses

Other names 1

• Portland Psychiatric Services, LLC Doing business as

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1902493620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 MOUNTFORT RD",
            "city": "NORTH YARMOUTH",
            "state": "ME",
            "postal_code": "040976926",
            "telephone_number": "207-550-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 COMMERCIAL ST STE 300",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041016606",
            "telephone_number": "207-470-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND PSYCHIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-550-2162",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portland Psychiatric Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.