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General NPI Number Information
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NPI Number | 1508770819
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Entity Type | Organization
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Legal Business Name | MARIA MANCEBO PHD, LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 154 WATERMAN ST STE 7
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City | PROVIDENCE
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State | RI
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Zip | 02906-3116
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Country | US
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Telephone | 401-361-4753
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Fax | 401-340-1675
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Provider Business Mailing Address
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Address Line | PO BOX 7041
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City | CUMBERLAND
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State | RI
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Zip | 02864-0892
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Country | US
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Telephone | 401-361-4753
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Fax | 401-340-1675
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARA CELMIRA MANCEBO COLTEY
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Credential | PHD
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Telephone | 401-862-7060
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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 | NULL
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State | NULL
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Taxonomy #3
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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 | NULL
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Taxonomy #4
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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 | NULL
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