Healthcare Provider Details

I. General information

NPI: 1164331872
Provider Name (Legal Business Name): HARRIET THOMAS MHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SMITH ST
PROVIDENCE RI
02908-2729
US

IV. Provider business mailing address

1000 SMITH ST
PROVIDENCE RI
02908-2729
US

V. Phone/Fax

Practice location:
  • Phone: 401-808-6013
  • Fax: 401-270-1025
Mailing address:
  • Phone: 401-808-6013
  • Fax: 401-270-1025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00487-A
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: