Healthcare Provider Details

I. General information

NPI: 1679481246
Provider Name (Legal Business Name): DEYBI PINEDA LMHC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 HOPE ST
PROVIDENCE RI
02906-2599
US

IV. Provider business mailing address

528 N MAIN ST UNIT 4
PROVIDENCE RI
02904-5770
US

V. Phone/Fax

Practice location:
  • Phone: 401-276-4020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00516-A
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: