| Pvd Psychological Associates | |
|
382 Thayer St Providence RI 02906-1558 | |
| (401) 330-5882 | |
| (401) 226-0137 |
| Full Name | Pvd Psychological Associates |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 382 Thayer St, Providence, Rhode Island |
| Authorized Official Name and Position | Nicole Issa (OWNER) |
| Authorized Official Contact | 4013305882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pvd Psychological Associates 11 S Angell St # 405 Providence RI 02906-5206 Ph: (401) 330-5882 | Pvd Psychological Associates 382 Thayer St Providence RI 02906-1558 Ph: (401) 330-5882 |
| NPI Number | 1790207876 |
|---|---|
| Provider Enumeration Date | 07/11/2017 |
| Last Update Date | 07/25/2021 |
| Certification Date | 07/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790207876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS01616 (Rhode Island) | Primary |
| 103TC0700X | Psychologist - Clinical | PS01615 (Rhode Island) | Secondary |
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