Individual provider Active NPI

Tanille Leana Louis, MS, PHMNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cranston, RI
National Provider Identifier
1922541465
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2298328 Issued in MA
Practice address
1200 Reservoir Ave
Cranston, RI 02920-6012
Phone
(401) 919-0406
NPI assigned
Dec 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN01719 RI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2298328 MA Primary

Addresses

Primary practice location

1200 Reservoir Ave
Cranston, RI 02920-6012

Mailing address

425 Lake Ave N
Worcester, MA 01605-2072
Phone (401) 919-0406

Other practice location 1

425 Lake Ave N
Worcester, MA 01605-2072
Phone (508) 753-3220

Other practice location 2

2348 Post Rd Ste 107
Warwick, RI 02886-2271
Phone (401) 681-4637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170321000927 MA Practitioner - Nurse Practitioner 9234414954 Reassigns benefits to 1 organization
I20231023001282 RI Practitioner - Nurse Practitioner 9234414954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Psych Services LLCGroup PAC ID 2961667498, 19 clinicians

Practice addresses (Care Compare)

1200 Reservoir Ave
Cranston, RI 02920-6012
Phone (401) 484-3094

425 Lake Ave N
Suite 101
Worcester, MA 01605-2073
Phone (508) 753-3220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
RN2298328MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psych Services, LLC CurrentSince Nov 11, 2017 Accepting new patients
Core of Hope Psychiatry LLC Psychiatric/Mental Health CurrentSince Aug 23, 2023 Accepting new patients
High Point Treatment Center Inc. Past Accepting new patients

Locations

425 Lake Ave N
Ste 101
Worcester, MA 01605
Phone (508) 753-3220

108 Grove St
Worcester, MA 01605
Phone (508) 753-3220

1200 Reservoir Ave
Cranston, RI 02920
Phone (401) 484-3094

Interoperability endpoints

  • Direct secure messaging: tanille.louis@iccworcester.direct.emds.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1922541465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052072",
            "telephone_number": "401-919-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206012",
            "telephone_number": "401-919-0406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052072",
            "country_code": "US",
            "telephone_number": "508-753-3220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2348 Post Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862271",
            "country_code": "US",
            "telephone_number": "401-681-4637",
            "fax_number": "401-681-4675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUIS",
        "first_name": "TANILLE",
        "middle_name": "LEANA",
        "credential": "MS, PHMNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN01719",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2298328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.