Healthcare Provider Details

I. General information

NPI: 1386200558
Provider Name (Legal Business Name): SHARAYA MCFADDEN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BALD HILL RD STE 530
WARWICK RI
02886-6111
US

IV. Provider business mailing address

42 NICHOLS RD
NORTH KINGSTOWN RI
02852-2032
US

V. Phone/Fax

Practice location:
  • Phone: 401-349-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS01756
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: