| Authentic Change Psychotherapy, Inc. | |
|
154 Waterman St. Suite 15, 3rd Floor Providence RI 02906 | |
| (401) 489-6885 | |
| Not Available |
| Full Name | Authentic Change Psychotherapy, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 154 Waterman St., Providence, Rhode Island |
| Authorized Official Name and Position | Brooke Huminski (OWNER) |
| Authorized Official Contact | 4014896885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Change Psychotherapy, Inc. 133 Glenwood Ave Pawtucket RI 02860-5905 Ph: (401) 489-6885 | Authentic Change Psychotherapy, Inc. 154 Waterman St. Suite 15, 3rd Floor Providence RI 02906 Ph: (401) 489-6885 |
| NPI Number | 1144971342 |
|---|---|
| Provider Enumeration Date | 01/10/2022 |
| Last Update Date | 01/23/2022 |
| Certification Date | 01/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144971342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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