Healthcare Provider Details

I. General information

NPI: 1417785189
Provider Name (Legal Business Name): INFORMED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 GREENVILLE AVE UNIT E
JOHNSTON RI
02919-2656
US

IV. Provider business mailing address

269 GREENVILLE AVE UNIT E
JOHNSTON RI
02919-2656
US

V. Phone/Fax

Practice location:
  • Phone: 401-777-7924
  • Fax: 401-443-8833
Mailing address:
  • Phone: 401-777-7924
  • Fax: 401-443-8833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KRYSTAL MACHADO
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSYD
Phone: 401-777-7924