Healthcare Provider Details

I. General information

NPI: 1124952171
Provider Name (Legal Business Name): HOPE, HEALING & HOLISTIC PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 WATERMAN ST
PROVIDENCE RI
02906-3116
US

IV. Provider business mailing address

331 RIVER AVE
PROVIDENCE RI
02908-4248
US

V. Phone/Fax

Practice location:
  • Phone: 401-251-0628
  • Fax: 401-340-1580
Mailing address:
  • Phone: 401-323-6148
  • Fax: 401-340-1580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NICOLE L FLANAGAN
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: PMHNPBC, MSN, RN, BA
Phone: 401-323-6148