Healthcare Provider Details

I. General information

NPI: 1942660584
Provider Name (Legal Business Name): RHODE ISLAND PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 BLACKSTONE BLVD
PROVIDENCE RI
02906-4800
US

IV. Provider business mailing address

171 SEABREEZE DR
NORTH KINGSTOWN RI
02852-4040
US

V. Phone/Fax

Practice location:
  • Phone: 401-455-6599
  • Fax:
Mailing address:
  • Phone: 781-775-4883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberPS01476
License Number StateRI

VIII. Authorized Official

Name: EMILY GENTES
Title or Position: SOLE PROPRIETER
Credential: PHD
Phone: 781-775-4883