Healthcare Provider Details

I. General information

NPI: 1790689495
Provider Name (Legal Business Name): STEPHANIE FAITH SAINTCLAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHLAND AVE STE 100
PROVIDENCE RI
02906-2740
US

IV. Provider business mailing address

115 BOURNE AVE APT 6
RUMFORD RI
02916-2742
US

V. Phone/Fax

Practice location:
  • Phone: 401-383-5051
  • Fax: 401-432-7082
Mailing address:
  • Phone: 401-383-5051
  • Fax: 401-432-7082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDP01062
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: