Divine Neuropsychiatric Services

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DIVINE NEUROPSYCHIATRIC SERVICES

Practice address

25751 149TH Rd
Rosedale, NY 11422-3022

Phone

(718) 812-2655

NPI assigned

Dec 2, 2020

Organization subpart

No

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

Authorized official

Name

Bolanle BelloNPI 1013160613

Title

Owner

Phone

(718) 812-2655

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bolanle Olajumoke Bello, N.P

  • Psychiatric/Mental Health Nurse Practitioner
  • Bronx, NY
  • NPI 1013160613
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606867200000",
    "number": "1033714555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25751 149TH RD",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114223022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25751 149TH RD",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114223022",
            "telephone_number": "718-812-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE NEUROPSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "BELLO",
        "authorized_official_first_name": "BOLANLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-812-2655"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandre Deus, LMSW
• Tere Hope Dickson, MD, MPH
• Diva Multicare Services Inc.
• Farah Divers
• Divine Medical LLC
• Jasmin Doris, OTD, OTR/L
• Marie Dormevil
• Cindly Dorsainvil
• Daniela Dorsainvil
• Clifton Douyon

• Psychiatric/Mental Health Nurse Practitioner in Rosedale, NY
• Providers in Rosedale, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.