Healthcare Provider Details

I. General information

NPI: 1578052056
Provider Name (Legal Business Name): THE CENTER FOR SOCIAL EMOTIONAL ENRICHMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 05/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MARTIN ST UNIT 3
CUMBERLAND RI
02864-5361
US

IV. Provider business mailing address

18 CURRAN RD
CUMBERLAND RI
02864-8002
US

V. Phone/Fax

Practice location:
  • Phone: 401-533-7213
  • Fax:
Mailing address:
  • Phone: 401-692-9390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STASIA DOMPKOWSKI-MANN
Title or Position: OWNER
Credential: LMHC
Phone: 401-692-9390