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General NPI Number Information
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NPI Number | 1073666913
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Entity Type | Organization
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Legal Business Name | MARTHA DEMPSTER, LICSW, LLC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1130 TEN ROD RD SUITE D-104
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-4180
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Country | US
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Telephone | 401-935-9784
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Fax | 401-295-5552
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Provider Business Mailing Address
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Address Line | 1130 TEN ROD RD SUITE D-104
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-4180
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Country | US
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Telephone | 401-935-9784
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Fax | 401-295-5552
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARTHA DEMPSTER
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Credential | LICSW
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Telephone | 401-935-9784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | ISW01537
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License Number State | RI
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