Healthcare Provider Details

I. General information

NPI: 1285519439
Provider Name (Legal Business Name): KAYLEAH PENSALFINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 AQUIDNECK AVE STE 202A
MIDDLETOWN RI
02842-5278
US

IV. Provider business mailing address

31 SUSAN CIR
JOHNSTON RI
02919-6419
US

V. Phone/Fax

Practice location:
  • Phone: 774-930-6729
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: