Healthcare Provider Details

I. General information

NPI: 1629689666
Provider Name (Legal Business Name): PSYCHIATRIC ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 BEDFORD ST
FALL RIVER MA
02723-2637
US

IV. Provider business mailing address

115 HIGH ST
BRISTOL RI
02809-2125
US

V. Phone/Fax

Practice location:
  • Phone: 401-477-4681
  • Fax: 508-567-6494
Mailing address:
  • Phone: 401-477-4681
  • Fax: 508-567-6494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: GINA DIGATI
Title or Position: PSYCHIATRIC CLINICAL NURSE SPECIALI
Credential: PCNS
Phone: 401-477-4681