| Me Psychotherapy, Llc | |
|
194 Waterman St Providence RI 02906-4015 | |
| (401) 633-2929 | |
| (888) 602-6957 |
| Full Name | Me Psychotherapy, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 194 Waterman St, Providence, Rhode Island |
| Authorized Official Name and Position | Marisa Etting (PRESIDENT) |
| Authorized Official Contact | 4016332929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Me Psychotherapy, Llc 194 Waterman St Providence RI 02906-4015 Ph: (401) 633-2929 | Me Psychotherapy, Llc 194 Waterman St Providence RI 02906-4015 Ph: (401) 633-2929 |
| NPI Number | 1043502214 |
|---|---|
| Provider Enumeration Date | 05/06/2011 |
| Last Update Date | 12/31/2024 |
| Certification Date | 12/31/2024 |
| Medicare PECOS PAC ID | 4183075302 |
|---|---|
| Medicare Enrollment ID | O20240111002419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043502214 | NPI | - | NPPES |
| Provider Name | Kathleen Reilly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417659962 PECOS PAC ID: 9830540053 Enrollment ID: I20240111002708 |
| Provider Name | Marisa E Etting |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598720187 PECOS PAC ID: 6901257120 Enrollment ID: I20240814001460 |
| Provider Name | Sana Kalra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376399626 PECOS PAC ID: 0749729440 Enrollment ID: I20240826003582 |
| Provider Name | Tyler Puryear |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609527365 PECOS PAC ID: 6507307915 Enrollment ID: I20240925000171 |
| Provider Name | Kimberly Masterson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770728198 PECOS PAC ID: 1658806013 Enrollment ID: I20241121002162 |
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