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General NPI Number Information
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NPI Number | 1417743402
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Entity Type | Organization
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Legal Business Name | SKR PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 295 GOVERNOR ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-3241
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Country | US
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Telephone | 401-363-0896
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Fax |
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Provider Business Mailing Address
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Address Line | 162 CAMDEN RD
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City | NARRAGANSETT
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State | RI
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Zip | 02882-2123
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Country | US
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Telephone | 617-697-6575
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN RESNICK
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Credential | LICSW
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Telephone | 617-697-6575
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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 |
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License Number State |
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