Healthcare Provider Details

I. General information

NPI: 1083130157
Provider Name (Legal Business Name): SEAN DAVID CARMICHAEL PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2017
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 POST RD
WARWICK RI
02888-3363
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 401-785-0040
  • Fax: 401-941-7847
Mailing address:
  • Phone: 401-785-0040
  • Fax: 401-941-7847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS02392
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: