Healthcare Provider Details

I. General information

NPI: 1336775634
Provider Name (Legal Business Name): CAREIN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 KNOWLES ST
PROVIDENCE RI
02906-1839
US

IV. Provider business mailing address

215 FOREST AVE
MIDDLETOWN RI
02842-7419
US

V. Phone/Fax

Practice location:
  • Phone: 401-536-8436
  • Fax:
Mailing address:
  • Phone: 401-536-8436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: ROBERT WILSON
Title or Position: THERAPIST/MANAGER
Credential: LMHC
Phone: 401-536-8436