Healthcare Provider Details

I. General information

NPI: 1659839785
Provider Name (Legal Business Name): KINDRED CONNECTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 BAY SPRING AVE
BARRINGTON RI
02806-1393
US

IV. Provider business mailing address

166 BAY SPRING AVE
BARRINGTON RI
02806-1393
US

V. Phone/Fax

Practice location:
  • Phone: 401-297-2218
  • Fax:
Mailing address:
  • Phone: 401-297-2218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. JESSICA L TOBIN
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 401-297-2218