| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 155 Main Rd, Tiverton, Rhode Island |
| Authorized Official Name and Position | Geraldine Feldman (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4016621419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
155 Main Rd Tiverton RI 02878-1236 Ph: (401) 624-7473 | 155 Main Rd Tiverton RI 02878-1236 Ph: (401) 624-7473 |
| NPI Number | 1508264565 |
|---|---|
| Provider Enumeration Date | 12/08/2014 |
| Last Update Date | 12/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508264565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | ISW02489 (Rhode Island) | Primary |
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