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General NPI Number Information
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NPI Number | 1336591494
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Entity Type | Organization
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Legal Business Name | OM THERAPY
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 1 RICHMOND SQ STE 350W
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City | PROVIDENCE
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State | RI
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Zip | 02906-5165
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Country | US
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Telephone | 401-227-0372
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Fax | 877-455-9466
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Provider Business Mailing Address
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Address Line | 1 RICHMOND SQ STE 350W
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City | PROVIDENCE
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State | RI
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Zip | 02906-5165
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Country | US
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Telephone | 401-227-0372
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Fax | 877-455-3466
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA DASILVA
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Credential | LICSW
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Telephone | 401-497-8873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW02064
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License Number State | RI
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