MEDICARE: JO PSYCHOTHERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1457292187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JO PSYCHOTHERAPY LLC

Provider Business Mailing Address
First Line	:	57 EXCHANGE ST STE 203
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04101-5000
Country	:	US
Telephone Number	:	207-200-3229
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 EXCHANGE ST STE 203
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04101-5000
Country	:	US
Telephone Number	:	207-200-3229
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST/OWNER
Name	:	JULES OLBRANTZ
Credential	:	LCSW
Telephone Number	:	207-200-3229

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “JO PSYCHOTHERAPY LLC ” Practice Location

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