is a Mental Health in Providence, Rhode Island. practices all healthcare services and medical treatments related to Mental Health. The NPI Number for is 1962514869. The last update date is .
's current location address is 110 Elmwood Ave, Providence, Rhode Island. You can contact this provider via phone number 4014326029 and fax number 4013005656. The mailing address for is 110 Elmwood Ave, Providence, Rhode Island. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 110 Elmwood Ave, Providence, Rhode Island |
| Phone Number | 4014326029 |
| Fax Number | 4013005656 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1962514869 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 110 Elmwood Ave |
|---|---|
| City | Providence |
| State | Rhode Island (RI) |
| Post Code | 29072423 |
| Phone Number | 4014326029 |
| Fax Number | 4013005656 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | MHC00235 |
|
Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 412210 | RI | BLUE CHIP | |
| 29290 8 | RI | BLUE CROSS | |
| LJ55332 | RI | -- |
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