DR. BRIAN M. DENIETOLIS (NPI# 1396012373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396012373 |
Entity Type | Individual |
Full Name | DR. BRIAN M. DENIETOLIS |
Credential | PSY.D. |
Practice Address |
305 Belmont St Umass Adolescent Continuing Care Unit Worcester MA 01604-1681 |
Mailing Address |
411 Village St Millis MA 02054-1736 |
Practice Telephone | 5083683756 |
Mailing Telephone | 5088435009 |
Enumeration Date | 2011-11-19 |
Last Update Date | 2011-11-19 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 103TC0700X |
Psychologist Specialization: Clinical |
9444 | MA | Behavioral Health & Social Service Providers |
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
9444 | MA | Behavioral Health & Social Service Providers |
Street Address |
305 BELMONT ST UMASS ADOLESCENT CONTINUING CARE UNIT |
City | WORCESTER |
State | MA |
Zip Code | 01604-1681 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033156609 | Sarah S Spratt | Psychiatry & Neurology | 305 Belmont St, Worcester State Hospital, Worcester, MA 01604-1681 | 2006-06-01 |
1790129336 | Subrath Subedi | Social Worker | 305 Belmont St, Department of Mental Health - Central West Area, Worcester, MA 01604-1681 | 2013-04-25 |
1912292418 | Judith Eleanor Lancey | Social Worker | 305 Belmont St, Worcester, MA 01604-1681 | 2011-06-13 |
1801193370 | Heather Ann Sagan | Physician Assistant | 305 Belmont St, Worcester State Hospital, Worcester, MA 01604-1681 | 2011-02-18 |
1144466772 | Ralph Nalbandian | Social Worker | 305 Belmont St, Worcester, MA 01604-1681 | 2009-01-03 |
1942402292 | Kathleen Marie Hickey | Social Worker | 305 Belmont St, 7c, Worcester, MA 01604-1681 | 2007-05-31 |
1356569149 | Department of Mental Health | Case Management | 305 Belmont St, Worcester Cm, Worcester, MA 01604-1681 | 2007-04-24 |
1063630838 | Department of Mental Health | Community/Behavioral Health | 305 Belmont St, Central Mass Rho, Worcester, MA 01604-1681 | 2007-04-24 |
1376767830 | Adalberto Rivera-vega | Social Worker | 305 Belmont St, Worcester, MA 01604-1681 | 2007-04-13 |
1780720292 | Denise L. Mumley | Psychologist | 305 Belmont St, Wsh - Forensic Service, Worcester, MA 01604-1681 | 2007-01-30 |
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1942839832 | Nicole Elizabeth Lewandrowski | Student in an Organized Health Care Education/Training Program | Pathology-1 Innovation Drive, Biotech 3, Worcester, MA 01604 | 2020-04-03 |
1285123034 | Sandra Jean Golden | Social Worker | 240 Belmont Street, Worcester, MA 01604 | 2018-05-08 |
1669961348 | Cindy Truong Choe | Behavior Technician | 330 Southwest Cutoff Suite 203, Worcester, MA 01604 | 2018-05-08 |
1013412915 | Michelle Marie Gaudet | Behavioral Analyst | 330 Southwest Cutoff, Suite 203, Worcester, MA 01604 | 2018-03-24 |
1104336593 | Younghwa Kim | Counselor | 2 Granite Street, Worcester, MA 01604 | 2017-10-11 |
1134640857 | Desiree Oquendo | Developmental Therapist | 43 Dillon Street, Worcester, MA 01604 | 2017-07-03 |
1457803686 | Reliable Home Care Services | Foster Care Agency | 35a Houghton Strret, Worcester, MA 01604 | 2016-11-04 |
1639530876 | Emily Capstick | Counselor | 81 Plantation Steet, Worcester, MA 01604 | 2016-03-16 |
1144696519 | Christian Caban I | Developmental Therapist | 25 Orient St, Worcester, MA 01604 | 2015-08-19 |
1750770160 | Ayanna Ortiz | Developmental Therapist | 16 Bangor St, Worcester, MA 01604 | 2015-01-22 |
Find all providers in zip 01604 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467068866 | Idaliana Medina | Psychologist | 11 Sycamore St, Worcester, MA 01608-2213 | 2020-09-21 |
1730667114 | Catherine Luckhardt | Psychologist | 335 Chandler St, Worcester, MA 01602-3441 | 2018-07-30 |
1962739078 | Marianne Heslington Tichovolsky | Psychologist | 275 Belmont St, Worcester, MA 01604-1675 | 2009-11-10 |
1295903888 | Caroline Cole | Psychologist | 21 Cedar St, Worcester, MA 01609-2530 | 2008-02-15 |
1477699171 | Beth M Ashenburg | Psychologist | 30 Sever St, Worcester, MA 01609-2194 | 2007-01-29 |
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1184247132 | Lauren R Blakely | Psychologist | 96 Fairbanks Ave, Wellesley, MA 02481-5256 | 2020-05-26 |
1881220986 | Katharine Dunson Oconnell | Psychologist | 144 Forest St, Wellesley Hills, MA 02481-6832 | 2020-03-20 |
1710457577 | Karla Lizbet Rivas | Psychologist | 44 Mansfield St, Allston, MA 02134 | 2018-12-04 |
1497230684 | Marisa Katherine Glynn | Psychologist | 35 Edgar Avenue, Somerville, MA 02145 | 2018-10-03 |
1043706419 | Jessica Shepley | Psychologist | 72 Fox Hill Rd, Bernardston, MA 01337-9586 | 2018-07-09 |
1548755176 | Elizabeth F Clark | Psychologist | 16 Gleasondale Rd, Stow, MA 01775-1465 | 2018-06-26 |
1528552619 | Heather Duckworth Smith | Psychologist | 5 Seal Cove Ln, Hingham, MA 02043-1050 | 2018-06-21 |
1467946251 | Olivia Moorehead-slaughter | Psychologist | 171 Goddard Ave, Brookline, MA 02445-7412 | 2018-06-15 |
1710479522 | David Arnold | Psychologist | 35 Hop Brook Rd, Amherst, MA 01002-2771 | 2018-06-06 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.