Healthcare Provider Details

I. General information

NPI: 1356270730
Provider Name (Legal Business Name): RAQUEL MCINTYRE APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CENTERVILLE RD STE 100
WARWICK RI
02886-0200
US

IV. Provider business mailing address

300 CENTERVILLE RD STE 100
WARWICK RI
02886-0200
US

V. Phone/Fax

Practice location:
  • Phone: 401-732-4500
  • Fax:
Mailing address:
  • Phone: 401-732-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberCAPRN05165
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: