Healthcare Provider Details

I. General information

NPI: 1538072798
Provider Name (Legal Business Name): INTERWOVEN RAINBOWS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 CEDAR POND DR APT 6
WARWICK RI
02886-0862
US

IV. Provider business mailing address

31 CEDAR POND DR APT 6
WARWICK RI
02886-0862
US

V. Phone/Fax

Practice location:
  • Phone: 765-543-7146
  • Fax:
Mailing address:
  • Phone: 765-543-7146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: RAI EURY
Title or Position: OWNER
Credential: LICSW
Phone: 765-543-7146