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NPI Code Detail

MEDICARE: INFINITI WELLNESS PLLC

MEDICARE: INFINITI WELLNESS PLLC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1760352215
Entity Type Code : Organization
Provider Name (Legal Business Name) : INFINITI WELLNESS PLLC
Provider Business Mailing Address
First Line : 82 WENDELL AVE STE 100
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-7066
Country : US
Telephone Number : 774-342-4925
Fax Number : 800-673-9052
Provider Business Practice Location Address
First Line : 82 WENDELL AVE STE 100
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-7066
Country : US
Telephone Number : 774-342-4925
Fax Number :
Authorized Official
Title or Position : PMHNP
Name : TARA ANN DOHERTY
Credential : DNP, RN, FNP, PMHNP
Telephone Number : 774-342-4925
Provider Enumeration Date : 11/10/2025
Last Update Date : 02/25/2026

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Directions to “INFINITI WELLNESS PLLC ” Practice Location

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