Healthcare Provider Details

I. General information

NPI: 1083528574
Provider Name (Legal Business Name): COMPASS COUNSELING AND PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2843 S COUNTY TRL STE 123
EAST GREENWICH RI
02818-1753
US

IV. Provider business mailing address

2843 S COUNTY TRL STE 123
EAST GREENWICH RI
02818-1753
US

V. Phone/Fax

Practice location:
  • Phone: 401-402-0018
  • Fax:
Mailing address:
  • Phone: 401-402-0018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. STACEY FONSECA
Title or Position: OWNER
Credential:
Phone: 401-402-0018