Opal Behavioral Health

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

OPAL BEHAVIORAL HEALTH

Practice address

383 W Fountain St Ste 103
Providence, RI 02903-3515

Phone

(401) 217-9377

Fax

(401) 200-3166

NPI assigned

Feb 14, 2023

Last updated

Apr 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susanna Draighan, APRNNPI 1417484254

Title

Owner

Phone

(401) 217-9377

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• Susanna Draighan, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Providence, RI
  • NPI 1417484254
  NPD Authorized official

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1851098479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 RINGGOLD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031432",
            "telephone_number": "401-217-9377",
            "fax_number": "401-200-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 W FOUNTAIN ST STE 103",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029033515",
            "telephone_number": "401-217-9377",
            "fax_number": "401-200-3166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Ringgold St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029031432",
            "country_code": "US",
            "telephone_number": "401-217-9377",
            "fax_number": "401-200-3166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPAL BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "DRAIGHAN",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-217-9377",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "RN2327944",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "APRN01685",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yashvin Onkarappa Mangala, MD
• Chukwuma Everestus Onuchukwu, MD
• Chineme Onwubueke
• Nwamaka Onwugbenu, MD
• Collette Chinwe Onyejekwe, PHARMD
• Opendoors
• Ophthalmology Inc (The Rhode Island Eye Institute)
• Ophthalmology Inc (The Rhode Island Eye Institute)
• Optimal Care & Transportation Services LP
• Optimom Birth LLC

• Psychiatric/Mental Health Nurse Practitioner in Providence, RI
• Providers in Providence, RI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.