MEDICARE: RASA LILA COUNSELING SERVICES LLC

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

General Provider Information

NPI Number	:	1750062436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RASA LILA COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	23 NORTH ROAD
Second Line	:	SUITE A-28 IN BUILDING A
City	:	SOUTH KINGSTOWN
State	:	RI
Zip	:	02879-2334
Country	:	US
Telephone Number	:	401-206-0493
Fax Number	:

Provider Business Practice Location Address
First Line	:	23 NORTH RD STE A28
Second Line	:
City	:	SOUTH KINGSTOWN
State	:	RI
Zip	:	02879-8108
Country	:	US
Telephone Number	:	401-206-0493
Fax Number	:

Authorized Official
Title or Position	:	LICENSED MENTAL HEALTH COUNSELOR
Name	:	CHAD COFFIN
Credential	:	MA
Telephone Number	:	401-206-0493

Provider Enumeration Date	:	07/26/2023
Last Update Date	:	08/26/2023

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