Healthcare Provider Details

I. General information

NPI: 1619814050
Provider Name (Legal Business Name): YOSELIN REYES TELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HOPE ST
PROVIDENCE RI
02906-2001
US

IV. Provider business mailing address

8 HENRY ST
PROVIDENCE RI
02909-5039
US

V. Phone/Fax

Practice location:
  • Phone: 401-331-1350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: