Organization Active NPI

Distinctive Ray Therapeutics

  • Psychiatric/Mental Health Nurse Practitioner
  • Pittsfield, MA
National Provider Identifier
1407664907
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
DISTINCTIVE RAY THERAPEUTICS
Practice address
82 Wendell Ave Ste 100
Pittsfield, MA 01201-7066
Phone
(857) 209-0778
Fax
(857) 209-0780
NPI assigned
Dec 30, 2024
Last updated
Dec 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Authorized official

Name
Mrs. Marsha V Charlton, NPNPI 1275994600
Title
Pmhnp
Phone
(857) 209-0778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

82 Wendell Ave Ste 100
Pittsfield, MA 01201-7066

Mailing address

82 Wendell Ave Ste 100
Pittsfield, MA 01201-7066
Phone (857) 209-0778

National Provider Directory

National Provider Directory

Locations

757 Gallivan Blvd
Ste 1
Dorchester, MA 02122
Phone (508) 237-7294

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1407664907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 WENDELL AVE STE 100",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012017066",
            "telephone_number": "857-209-0778",
            "fax_number": "857-209-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 WENDELL AVE STE 100",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012017066",
            "telephone_number": "857-209-0778",
            "fax_number": "857-209-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE RAY THERAPEUTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "CHARLTON",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "857-209-0778",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.