Healthcare Provider Details

I. General information

NPI: 1003773680
Provider Name (Legal Business Name): METTA PSYCHIATRY & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WAMPANOAG TRL UNIT 202
RIVERSIDE RI
02915-1019
US

IV. Provider business mailing address

1445 WAMPANOAG TRL UNIT 202
RIVERSIDE RI
02915-1019
US

V. Phone/Fax

Practice location:
  • Phone: 401-437-4116
  • Fax: 401-433-0367
Mailing address:
  • Phone: 401-437-4116
  • Fax: 401-433-0367

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: ALEXANDRA MACKENZIE
Title or Position: NURSE PRACTITIONER
Credential: APRN
Phone: 401-365-9930