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General NPI Number Information
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NPI Number | 1538039466
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Entity Type | Organization
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Legal Business Name | EAST SIDE PSYCHOTHERAPY, INC.
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 205 WATERMAN ST # 201
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City | PROVIDENCE
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State | RI
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Zip | 02906-4313
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Country | US
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Telephone | 401-263-2272
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Fax | 401-205-3345
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Provider Business Mailing Address
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Address Line | 205 WATERMAN ST # 201
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City | PROVIDENCE
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State | RI
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Zip | 02906-4313
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Country | US
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Telephone | 401-263-2272
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Fax | 401-205-3345
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELIZABETH ROBIN SHER
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Credential | MSW, LICSW
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Telephone | 401-263-2272
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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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