Healthcare Provider Details

I. General information

NPI: 1679442016
Provider Name (Legal Business Name): LENKA HORSAKOVA APRN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 GENERAL ST
PROVIDENCE RI
02904-1650
US

IV. Provider business mailing address

42 GENERAL ST
PROVIDENCE RI
02904-1650
US

V. Phone/Fax

Practice location:
  • Phone: 401-270-4649
  • Fax: 401-274-0656
Mailing address:
  • Phone: 401-270-4649
  • Fax: 401-274-0656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number15620
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: