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General NPI Number Information
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NPI Number | 1770614745
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Entity Type | Individual
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Provider Name | JODIE DEIGNAN NPP, PMHNP-BC, MT-BC
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 180 S BROADWAY STE 301A
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City | WHITE PLAINS
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State | NY
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Zip | 10605-1820
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Country | US
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Telephone | 914-216-7550
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Fax | 412-900-1132
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Provider Business Mailing Address
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Address Line | 55 MCKINLEY AVE APT DG-8
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City | WHITE PLAINS
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State | NY
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Zip | 10606-1659
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Country | US
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Telephone | 508-317-2486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 6309491
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 12.010154
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2351852
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 401321
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License Number State | NY
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