Healthcare Provider Details

I. General information

NPI: 1730493941
Provider Name (Legal Business Name): THE THERAPY COLLABORATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 01/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 ANGELL ST STE 1A
PROVIDENCE RI
02906-2119
US

IV. Provider business mailing address

295 ANGELL ST STE 1A
PROVIDENCE RI
02906-2119
US

V. Phone/Fax

Practice location:
  • Phone: 401-654-4618
  • Fax: 401-383-9133
Mailing address:
  • Phone: 401-654-4618
  • Fax: 401-383-9133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMHC00438
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00438
License Number StateRI

VIII. Authorized Official

Name: DR. KATE SINER FRANCIS
Title or Position: FOUNDER
Credential: PH.D LMHC
Phone: 401-654-4618