Healthcare Provider Details

I. General information

NPI: 1386845642
Provider Name (Legal Business Name): NEWPORT COUNTY COMMUNITY MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 VALLEY RD
MIDDLETOWN RI
02842-6371
US

IV. Provider business mailing address

735 WILLETT AVE UNIT 905
RIVERSIDE RI
02915-2600
US

V. Phone/Fax

Practice location:
  • Phone: 401-848-6363
  • Fax:
Mailing address:
  • Phone: 401-632-4514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE MARIE KASHETA
Title or Position: CIS THERAPIST
Credential: MSW
Phone: 401-848-6363