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NPI Code Detail

MEDICARE: PSYCHIATRIC ASSOCIATES, LLC

MEDICARE: PSYCHIATRIC ASSOCIATES, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1364SP0809XAdult Psychiatric/Mental Health Clinical Nurse Specialist

General Provider Information

NPI Number : 1629689666
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSYCHIATRIC ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 115 HIGH ST
Second Line :
City : BRISTOL
State : RI
Zip : 02809-2125
Country : US
Telephone Number : 401-477-4681
Fax Number : 508-567-6494
Provider Business Practice Location Address
First Line : 1311 BEDFORD ST
Second Line :
City : FALL RIVER
State : MA
Zip : 02723-2637
Country : US
Telephone Number : 401-477-4681
Fax Number : 508-567-6494
Authorized Official
Title or Position : PSYCHIATRIC CLINICAL NURSE SPECIALI
Name : GINA DIGATI
Credential : PCNS
Telephone Number : 401-477-4681
Provider Enumeration Date : 08/13/2020
Last Update Date : 08/13/2020

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