Healthcare Provider Details

I. General information

NPI: 1104491034
Provider Name (Legal Business Name): MICHELLE ECHE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 BLACKSTONE BLVD STE 127
PROVIDENCE RI
02906-4800
US

IV. Provider business mailing address

345 BLACKSTONE BLVD STE 127
PROVIDENCE RI
02906-4800
US

V. Phone/Fax

Practice location:
  • Phone: 401-455-6528
  • Fax: 401-455-6494
Mailing address:
  • Phone: 401-455-6528
  • Fax: 401-455-6494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: