Healthcare Provider Details

I. General information

NPI: 1578248357
Provider Name (Legal Business Name): ICAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 NAPLES AVE
PROVIDENCE RI
02908-1222
US

IV. Provider business mailing address

26 NAPLES AVE
PROVIDENCE RI
02908-1222
US

V. Phone/Fax

Practice location:
  • Phone: 401-487-8298
  • Fax: 401-274-0923
Mailing address:
  • Phone: 401-487-8298
  • Fax: 401-274-0923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0813X
TaxonomyGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. BARBARA FORLONEY
Title or Position: PRESIDENT
Credential: APRN, CNS, CNP
Phone: 401-323-6237