=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023829157
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARI L. CUESTA, LMHC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2025
-----------------------------------------------------
Last Update Date | 01/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 982 TIOGUE AVE STE 210
-----------------------------------------------------
City | COVENTRY
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02816-6116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-954-5929
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 982 TIOGUE AVE STE 210
-----------------------------------------------------
City | COVENTRY
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02816-6116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-954-5929
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. CARI CUESTA
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 401-954-5929
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------