Healthcare Provider Details

I. General information

NPI: 1730895699
Provider Name (Legal Business Name): CHELSEA LEIGH LOMASTRO LMHC, LCDP, LCDCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 TOWER HILL RD
NORTH KINGSTOWN RI
02852-6639
US

IV. Provider business mailing address

900 POST RD APT 14
WARWICK RI
02888-3339
US

V. Phone/Fax

Practice location:
  • Phone: 401-294-6160
  • Fax: 401-294-4116
Mailing address:
  • Phone: 401-256-2103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number19801
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDP00791
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC01475
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: