MEDICARE: MR. RICHARD F SANTOPIETRO MA

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
1	101YM0800X	Mental Health Counselor	MHC00543	RI

General Provider Information

NPI Number	:	1417209206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD F SANTOPIETRO MA

Provider Business Mailing Address
First Line	:	1130 TEN ROD ROAD
Second Line	:	SUITE A102
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4128
Country	:	US
Telephone Number	:	401-301-9677
Fax Number	:	401-267-0105

Provider Business Practice Location Address
First Line	:	1130 TEN ROD ROAD
Second Line	:	SUITE A102
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4128
Country	:	US
Telephone Number	:	401-301-9677
Fax Number	:	401-267-0105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2012
Last Update Date	:	10/04/2012

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