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NPI 1003773680

NPI 1003773680 : METTA PSYCHIATRY & WELLNESS, LLC : RIVERSIDE, RI

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General NPI Number Information
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    NPI Number           |    1003773680
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    Entity Type          |    Organization 
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    Legal Business Name  |    METTA PSYCHIATRY & WELLNESS, LLC 
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Dates
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    Enumeration Date     |    01/06/2026
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    Last Update Date     |    01/06/2026
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Provider Practice Location Address
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    Address Line         |    1445 WAMPANOAG TRL UNIT 202 
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    City                 |    RIVERSIDE
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    State                |    RI
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    Zip                  |    02915-1019
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    Country              |    US
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    Telephone            |    401-437-4116
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    Fax                  |    401-433-0367
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Provider Business Mailing Address
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    Address Line         |    1445 WAMPANOAG TRL UNIT 202 
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    City                 |    RIVERSIDE
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    State                |    RI
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    Zip                  |    02915-1019
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    Country              |    US
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    Telephone            |    401-437-4116
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    Fax                  |    401-433-0367
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Authorized Official
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    Title or Position    |    NURSE PRACTITIONER
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    Name                 |     ALEXANDRA  MACKENZIE 
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    Credential           |    APRN
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    Telephone            |    401-365-9930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    
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    License Number State |    
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