Healthcare Provider Details

I. General information

NPI: 1134722929
Provider Name (Legal Business Name): TRUE SELF THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CANAL ST STE 2
WESTERLY RI
02891-1579
US

IV. Provider business mailing address

107 BOOMBRIDGE RD
WESTERLY RI
02891-1017
US

V. Phone/Fax

Practice location:
  • Phone: 401-932-0160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIN PRINGER
Title or Position: OWNER
Credential: LICSW
Phone: 401-932-0160