=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497528707
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SYNODIC HEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2023
-----------------------------------------------------
Last Update Date | 05/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 82 WENDELL AVE STE 100
-----------------------------------------------------
City | PITTSFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01201-7066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-300-3445
-----------------------------------------------------
Fax | 774-300-3907
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 82 WENDELL AVE STE 100
-----------------------------------------------------
City | PITTSFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01201-7066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-300-3445
-----------------------------------------------------
Fax | 774-300-3907
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHRISTINA MITCHELL
-----------------------------------------------------
Credential | CPNP-PC, PMHNP-BC
-----------------------------------------------------
Telephone | 774-300-3422
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------