Healthcare Provider Details

I. General information

NPI: 1437060191
Provider Name (Legal Business Name): CHARLES MAHDY PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US

IV. Provider business mailing address

321 WALNUT ST # 302
NEWTON MA
02460-1927
US

V. Phone/Fax

Practice location:
  • Phone: 617-221-1390
  • Fax: 617-221-1391
Mailing address:
  • Phone: 617-221-1390
  • Fax: 617-221-1391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHARLES MAHDY
Title or Position: OWNER/MANAGER
Credential: PMHNP
Phone: 617-221-1390