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General NPI Number Information
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NPI Number | 1114582806
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Entity Type | Organization
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Legal Business Name | ASPIRE PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1130 TEN ROD RD STE C205D
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-4167
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Country | US
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Telephone | 860-888-3833
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 TEN ROD RD STE C205D
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-4167
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Country | US
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Telephone | 860-888-3833
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILLIP DANG
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Credential | PSY.D.
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Telephone | 860-888-3833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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