| NPI | 1376276832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADRONE B. PHOENIX Owner 401-441-5834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2022-07-02 |
| Last Update Date | 2025-02-26 |