Brian M. Denietolis, PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

9444 Issued in MA

Practice address

305 Belmont St
Umass Adolescent Continuing Care Unit
Worcester, MA 01604-1681

Phone

(508) 368-3756

NPI assigned

Nov 19, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1321660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321660800000",
    "number": "1396012373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 VILLAGE ST",
            "city": "MILLIS",
            "state": "MA",
            "postal_code": "020541736",
            "telephone_number": "508-843-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BELMONT ST",
            "address_2": "UMASS ADOLESCENT CONTINUING CARE UNIT",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041681",
            "telephone_number": "508-368-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIETOLIS",
        "first_name": "BRIAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-19",
        "last_updated": "2011-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9444",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "9444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arianna Deneault
• Meghan Deneen
• Linda Denering, RD
• Mam G Deng Madout, MD
• Cay E Denherder, M.D.
• Courtney Denis
• Samantha Denis
• Mary Denman
• William S Dennett, RPH
• Dennis J. Arinella, M.D.,P.C.

• Clinical Child & Adolescent Psychologist in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Child & Adolescent Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; 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.