Healthcare Provider Details

I. General information

NPI: 1578899621
Provider Name (Legal Business Name): CARI LIN CUESTA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2009
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 TIOGUE AVE SUITE 2
COVENTRY RI
02816-6116
US

IV. Provider business mailing address

982 TIOGUE AVE SUITE 205
COVENTRY RI
02816-6116
US

V. Phone/Fax

Practice location:
  • Phone: 401-954-5929
  • Fax:
Mailing address:
  • Phone: 401-954-5929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00276
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: