| Michael Pendergast | |
|
1130 Ten Rod Rd Building D, Suite 307-c North Kingstown RI 02852-4161 | |
| (401) 301-4526 | |
| Not Available |
| Full Name | Michael Pendergast |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1130 Ten Rod Rd, North Kingstown, Rhode Island |
| Authorized Official Name and Position | Michael Cole Pendergast (LICENSED INDEPENDENT SOCIAL WORKER) |
| Authorized Official Contact | 4013014526 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Pendergast 1130 Ten Rod Rd Building D, Suite 307-c North Kingstown RI 02852-4161 Ph: (401) 301-4526 | Michael Pendergast 1130 Ten Rod Rd Building D, Suite 307-c North Kingstown RI 02852-4161 Ph: (401) 301-4526 |
| NPI Number | 1043660202 |
|---|---|
| Provider Enumeration Date | 06/20/2016 |
| Last Update Date | 06/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043660202 | NPI | - | NPPES |
| 1124181243 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | ISW01338 (Rhode Island) | Primary |
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