MEDICARE: INFORMED, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	103TC2200X	Clinical Child & Adolescent Psychologist
3	103TM1800X	Intellectual & Developmental Disabilities Psychologist
4	103TS0200X	School Psychologist
5	103G00000X	Clinical Neuropsychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417785189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFORMED, LLC

Provider Business Mailing Address
First Line	:	269 GREENVILLE AVE UNIT E
Second Line	:
City	:	JOHNSTON
State	:	RI
Zip	:	02919-2656
Country	:	US
Telephone Number	:	401-777-7924
Fax Number	:	401-443-8833

Provider Business Practice Location Address
First Line	:	269 GREENVILLE AVE UNIT E
Second Line	:
City	:	JOHNSTON
State	:	RI
Zip	:	02919-2656
Country	:	US
Telephone Number	:	401-777-7924
Fax Number	:	401-443-8833

Authorized Official
Title or Position	:	PSYCHOLOGIST/OWNER
Name	:	DR. KRYSTAL MACHADO
Credential	:	PSYD
Telephone Number	:	401-777-7924

Provider Enumeration Date	:	07/24/2024
Last Update Date	:	09/15/2025

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Directions to “INFORMED, LLC ” Practice Location

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