Healthcare Provider Details

I. General information

NPI: 1184199887
Provider Name (Legal Business Name): ARIELLE BRYANT LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MAPLE ST STE 200
PAWTUCKET RI
02860-2104
US

IV. Provider business mailing address

21366 HALL RD # 1096
CLINTON TWP MI
48038-1539
US

V. Phone/Fax

Practice location:
  • Phone: 601-255-7863
  • Fax: 213-606-8673
Mailing address:
  • Phone: 601-255-7863
  • Fax: 213-606-8673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT00268
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101007116
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: