Active NPI
Doreen Joanne D'Agostino, PMHNP, CRNP
- Psychiatric/Mental Health Nurse Practitioner
- Holyoke, MA
National Provider Identifier
1083081079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- SP015274
- Practice address
- 40 Bobala Rd
Mt Tom Center for Mental Health
Holyoke, MA 01040-9632 - Phone
- (413) 536-5473
- NPI assigned
- Aug 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | SP015274 | PA | Primary |
Addresses
Primary practice location
40 Bobala Rd
Mt Tom Center for Mental Health
Holyoke, MA 01040-9632
Mailing address
40 Bobala Rd
Mt Tom Center for Mental Health
Holyoke, MA 01040-9632
Phone (413) 536-5473
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP015274 | PA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476230400000",
"number": "1083081079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 BOBALA RD",
"address_2": "MT TOM CENTER FOR MENTAL HEALTH",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "010409632",
"telephone_number": "413-536-5473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 BOBALA RD",
"address_2": "MT TOM CENTER FOR MENTAL HEALTH",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "010409632",
"telephone_number": "413-536-5473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'AGOSTINO",
"first_name": "DOREEN",
"middle_name": "JOANNE",
"name_prefix": "Ms.",
"credential": "PMHNP, CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-26",
"last_updated": "2016-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "PA",
"license": "SP015274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holyoke, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.