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NPI Code Detail

MEDICARE: DR. HENRY R LESIEUR PSYD, PHD

MEDICARE: DR. HENRY R LESIEUR PSYD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TA0400XAddiction (Substance Use Disorder) PsychologistPS00787RI
2103TC0700XClinical PsychologistPS00787RI

General Provider Information

NPI Number : 1386620466
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HENRY R LESIEUR PSYD, PHD
Provider Business Mailing Address
First Line : 593 EDDY ST
Second Line : APC 970
City : PROVIDENCE
State : RI
Zip : 02903-4923
Country : US
Telephone Number : 401-277-0700
Fax Number : 401-277-0744
Provider Business Practice Location Address
First Line : 593 EDDY ST
Second Line : APC 970
City : PROVIDENCE
State : RI
Zip : 02903-4923
Country : US
Telephone Number : 401-277-0700
Fax Number : 401-277-0744
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 09/11/2025

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