Healthcare Provider Details

I. General information

NPI: 1134252794
Provider Name (Legal Business Name): FRANCIS R SPARADEO PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 TEN ROD RD STE E201
NORTH KINGSTOWN RI
02852-4168
US

IV. Provider business mailing address

1130 TEN ROD RD STE E201
NORTH KINGSTOWN RI
02852-4168
US

V. Phone/Fax

Practice location:
  • Phone: 401-398-7681
  • Fax: 401-615-9908
Mailing address:
  • Phone: 401-398-7681
  • Fax: 401-615-9908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPS00241
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS00241
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS00241
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: