Active NPI
Doreen Theresa Dagostino
- Mental Health Counselor
- White Bluff, TN
National Provider Identifier
1861216244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6033
- Practice address
- 1032 Johnston Dr
White Bluff, TN 37187-4739 - Phone
- (631) 235-7798
- NPI assigned
- Nov 12, 2024
- Last updated
- Nov 12, 2024
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6033 | TN | Primary |
Addresses
Primary practice location
1032 Johnston Dr
White Bluff, TN 37187-4739
Mailing address
1032 Johnston Dr
White Bluff, TN 37187-4739
Phone (631) 235-7798
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6033 | TN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1861216244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1032 JOHNSTON DR",
"city": "WHITE BLUFF",
"state": "TN",
"postal_code": "371874739",
"telephone_number": "631-235-7798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1032 JOHNSTON DR",
"city": "WHITE BLUFF",
"state": "TN",
"postal_code": "371874739",
"telephone_number": "631-235-7798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAGOSTINO",
"first_name": "DOREEN",
"middle_name": "THERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-12",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TN",
"license": "6033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Bluff, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.