Kathleen J Mongillo, MS,ARNP,BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R038450 Issued in ME

Practice address

200 Lancaster Street
Portland, ME 04101-2418

Phone

(207) 772-2133

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science, Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023064326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 S HIGH ST",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040093919",
            "telephone_number": "603-447-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LANCASTER STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012418",
            "telephone_number": "207-772-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGILLO",
        "first_name": "KATHLEEN",
        "middle_name": "J",
        "credential": "MS,ARNP,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "R038450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Molina-Heppe, DO
• Stephanie Mollica, LCSW
• Brianna Monahan, RDN
• Katrina Monahan, AGACNP
• Jamie Money, DNAP, CRNA, RN
• Catherine Monigan, DO
• Jeremy Joseph Moniz, CRNA
• Stephanie Moniz
• Robert Montague, CRNA
• Claudia Montenegro

• Psychiatric/Mental Health Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.