Healthcare Provider Details

I. General information

NPI: 1184538118
Provider Name (Legal Business Name): ANDREA SEPE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 BLACKSTONE BLVD
PROVIDENCE RI
02906-4800
US

IV. Provider business mailing address

397 GIBBS AVE
NEWPORT RI
02840-3379
US

V. Phone/Fax

Practice location:
  • Phone: 401-680-4178
  • Fax:
Mailing address:
  • Phone: 401-265-7678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC01787
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: