NPI Code Details Logo

NPI 1275446189

NPI 1275446189 : UNJADED CLINICAL : SOUTH KINGSTOWN, RI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1275446189
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    UNJADED CLINICAL 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/23/2026
-----------------------------------------------------
    Last Update Date     |    09/23/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    24 SALT POND RD STE G1 
-----------------------------------------------------
    City                 |    SOUTH KINGSTOWN
-----------------------------------------------------
    State                |    RI
-----------------------------------------------------
    Zip                  |    02879-4325
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    401-575-7873
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    107 WOODVILLE RD 
-----------------------------------------------------
    City                 |    HOPE VALLEY
-----------------------------------------------------
    State                |    RI
-----------------------------------------------------
    Zip                  |    02832-2427
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    401-575-7873
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     ALEXIS  DESJARDINS 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    401-575-7873
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.