Healthcare Provider Details

I. General information

NPI: 1518085505
Provider Name (Legal Business Name): NORTHEAST BEHAVIORAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2348 POST RD STE 107
WARWICK RI
02886-2271
US

IV. Provider business mailing address

2348 POST RD STE 107
WARWICK RI
02886-2271
US

V. Phone/Fax

Practice location:
  • Phone: 401-681-4637
  • Fax: 401-681-4675
Mailing address:
  • Phone: 401-681-4637
  • Fax: 401-681-4675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: NIDHI TURNER
Title or Position: COO
Credential:
Phone: 978-530-6605