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General NPI Number Information
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NPI Number | 1396509022
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Entity Type | Organization
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Legal Business Name | ISLAND COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 575 E MAIN RD UNIT 3A
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City | MIDDLETOWN
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State | RI
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Zip | 02842-5288
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Country | US
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Telephone | 401-344-9027
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Fax |
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Provider Business Mailing Address
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Address Line | 444 WATER ST
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City | PORTSMOUTH
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State | RI
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Zip | 02871-4227
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Country | US
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Telephone | 401-225-7586
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | KATE KEELTY
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Credential | LMHC
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Telephone | 401-344-9027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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