Healthcare Provider Details

I. General information

NPI: 1114177672
Provider Name (Legal Business Name): JODIE REGAN SEXTON MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2008
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 DRAPER AVE
WARWICK RI
02889-5047
US

IV. Provider business mailing address

148 DRAPER AVE
WARWICK RI
02889
US

V. Phone/Fax

Practice location:
  • Phone: 401-732-5000
  • Fax: 401-737-2302
Mailing address:
  • Phone: 401-732-5200
  • Fax: 401-737-2302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00702
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMHC00702
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: