Healthcare Provider Details

I. General information

NPI: 1568308914
Provider Name (Legal Business Name): SOLACE & HEALING COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 SLEEPY HOLLOW FARM RD
WARWICK RI
02886-0409
US

IV. Provider business mailing address

350 SLEEPY HOLLOW FARM RD
WARWICK RI
02886-0409
US

V. Phone/Fax

Practice location:
  • Phone: 401-368-9100
  • Fax:
Mailing address:
  • Phone: 401-368-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: RUDORWASHE CUSACK
Title or Position: COUNSELOR
Credential: LMHC
Phone: 401-368-9100