Healthcare Provider Details

I. General information

NPI: 1982532511
Provider Name (Legal Business Name): AUGUSTINE MENSAH MSN, PMHNP-BC, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 QUEEN ST
WORCESTER MA
01610-2411
US

IV. Provider business mailing address

PO BOX 20854
WORCESTER MA
01602-0854
US

V. Phone/Fax

Practice location:
  • Phone: 508-735-3588
  • Fax:
Mailing address:
  • Phone: 508-736-3588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2336086
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: