Healthcare Provider Details

I. General information

NPI: 1427709815
Provider Name (Legal Business Name): ERIN MEDEIROS LMHC, LCDP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 WAMPANOAG TRL STE 9
RIVERSIDE RI
02915-1217
US

IV. Provider business mailing address

1275 WAMPANOAG TRL STE 9
RIVERSIDE RI
02915-1217
US

V. Phone/Fax

Practice location:
  • Phone: 401-352-8440
  • Fax:
Mailing address:
  • Phone: 401-352-8440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDP00849
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC01691
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: