Katelyn R Agnew, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Riverside, RI
NPI 1972122364 · NPPES record last updated Aug 12, 2025
Key facts
- NPI
- 1972122364
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APRN02327 (RI)
- Practice address
- 205 Bullocks Point Ave Ste 2
Riverside, RI 02915-5336 - Phone
- (401) 433-9453
- Fax
- (401) 340-1650
- NPI assigned
- Apr 15, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200601002681 | RI | Practitioner - Nurse Practitioner | 6103247093 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN02327 | RI | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary & Psychiatric Integrated Care | Current |
Accepting new patients | |
| The Providence Center | Past | Accepting new patients | |
| Victorian Eye Care Inc. | Past |
Accepting new patients |
Locations
400 Bald Hill Rd
Ste 503
Warwick, RI 02886
Phone (401) 234-6685
215 Legris Ave
West Warwick, RI 02893
Phone (401) 234-6685
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN02327 | RI | Yes |
Addresses
Primary practice location
205 Bullocks Point Ave Ste 2
Riverside, RI 02915-5336
Mailing address
205 Bullocks Point Ave Ste 2
Riverside, RI 02915-5336
Phone (401) 433-9453
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kagnew@direct.carene.org | Health Information Exchange (HIE) |
Other providers in Riverside, RI
- J Gary Abuelo
- Yasin Abul
- Advanced Dentistry of Rhode Island LLC
- Adviniacare Orchard LLC
- Katelyn Affleck
- Mary Angeli Maganto Aguinaldo
- Jesus Ismael Aguirre Jr.
- Ahavah Home LLC
- Elizabeth J Alexander
- Hina Ali
All providers in Riverside, RI · Psychiatric/Mental Health Nurse Practitioner in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.