Healthcare Provider Details

I. General information

NPI: 1285025437
Provider Name (Legal Business Name): ANCHOR MEMORY CLINIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2015
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 GEORGE WASHINGTON HWY SUITE 102
LINCOLN RI
02865-4330
US

IV. Provider business mailing address

652 GEORGE WASHINGTON HWY SUITE 102
LINCOLN RI
02865-4330
US

V. Phone/Fax

Practice location:
  • Phone: 401-475-9979
  • Fax: 401-475-9917
Mailing address:
  • Phone: 401-475-9979
  • Fax: 401-475-9917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00565
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00469
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00660
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW02006
License Number StateRI
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW01751
License Number StateRI
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW01861
License Number StateRI
# 7
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT00161
License Number StateRI
# 8
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT00094
License Number StateRI
# 9
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS01358
License Number StateRI

VIII. Authorized Official

Name: MR. RICHARD FIGUEIRA
Title or Position: PRESIDENT
Credential: LICSW
Phone: 401-475-9979