# ADULLAM INTEGRATED PSYCHIATRY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265288658
- **Authorized official:** DERICK YENSILA NGORAN (PMHNP-BC)
- **Authorized official phone:** (701) 610-1994

## Contact information

- **Practice address:** 155 FEDERAL ST STE 700, BOSTON, MA 02110-1727
- **Practice address phone:** (701) 610-1994
- **Mailing address:** 155 FEDERAL ST STE 700, BOSTON, MA 02110-1727
- **Mailing address phone:** (701) 610-1994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/25/2024
- **Last updated:** 04/25/2024