=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780538637
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLACKSTONE PSYCHOLOGY GROUP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2026
-----------------------------------------------------
Last Update Date | 02/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 203 HUNTING HILL DR
-----------------------------------------------------
City | CUMBERLAND
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02864-2625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-439-3079
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 203 HUNTING HILL DR
-----------------------------------------------------
City | CUMBERLAND
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02864-2625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-439-3079
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER
-----------------------------------------------------
Name | MR. RAYMOND ALFONZO LAMBERT III
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 401-439-3079
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------