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DIVINE DESIGN PSYCHIATRY AND WELLNESS PLLC
NPI 1104779750
Nurse Practitioner - Psychiatric/Mental Health in O Fallon, IL

Active since February 16, 2026
853 CHESAPEAKE JUNCTION LN, O FALLON, IL 62269(217) 816-7928(616) 208-2675 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Divine Design Psychiatry And Wellness Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIVINE DESIGN PSYCHIATRY AND WELLNESS PLLC (NPI 1104779750) is a healthcare organization registered as a psychiatric/mental health in O Fallon, Illinois and active in the NPI registry since February 2026. The organization lists Angela Severado, Nurse Practitioner/owner, as its authorized official.

NPPES Registry Identity

NPI1104779750
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameDIVINE DESIGN PSYCHIATRY AND WELLNESS PLLC
Location Address853 CHESAPEAKE JUNCTION LNO Fallon, IL 62269-7035
Mailing Address853 Chesapeake Junction LnO Fallon, IL 62269-7035 · (217) 816-7928 · Fax (616) 208-2675
Phone(217) 816-7928
Fax(616) 208-2675
Organization SubpartNo
Authorized OfficialAngela SeveradoNurse Practitioner/owner · (217) 816-7928
Enumeration DateFebruary 16, 2026
Last NPPES UpdateMay 18, 2026
NPPES CertifiedMay 18, 2026
✔ NPI 1104779750 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
853 CHESAPEAKE JUNCTION LN, O Fallon, IL 62269
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Divine Design Psychiatry And Wellness PLLC's NPI number?

The NPI number for Divine Design Psychiatry And Wellness PLLC is 1104779750. It was assigned to this organization in the NPPES registry on February 16, 2026.

Where is Divine Design Psychiatry And Wellness PLLC located?

Divine Design Psychiatry And Wellness PLLC is located at 853 Chesapeake Junction Ln, O Fallon, IL 62269. The listed phone number is (217) 816-7928.

What is Divine Design Psychiatry And Wellness PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Divine Design Psychiatry And Wellness PLLC was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.