Healthcare Provider Details

I. General information

NPI: 1265344733
Provider Name (Legal Business Name): AXIS PSYCHIATRIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17182 72ND PL N
OSSEO MN
55311-4556
US

IV. Provider business mailing address

17182 72ND PL N
OSSEO MN
55311-4556
US

V. Phone/Fax

Practice location:
  • Phone: 617-653-1924
  • Fax:
Mailing address:
  • Phone: 617-653-1924
  • Fax:

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: PRAKRITI CHAULAGAIN
Title or Position: PSYCHIATRIC MENTAL HEALTH NP
Credential: DNP, PMHNP-BC
Phone: 617-653-1924