Healthcare Provider Details

I. General information

NPI: 1144005687
Provider Name (Legal Business Name): SHARON FAITH DIVITTO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 HEIGHTS OF HILL ST
WHITINSVILLE MA
01588-1050
US

IV. Provider business mailing address

128 HEIGHTS OF HILL ST
WHITINSVILLE MA
01588-1050
US

V. Phone/Fax

Practice location:
  • Phone: 508-243-9735
  • Fax:
Mailing address:
  • Phone: 508-243-9735
  • Fax:

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: MRS. SHARON FAITH DIVITTO
Title or Position: PSYCHIATRIC CLINICAL NURSE SPECIALI
Credential: RN PMH CNS BC
Phone: 508-243-9735