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General NPI Number Information
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NPI Number | 1790859619
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Entity Type | Individual
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Provider Name | JOHN D DAPONTE LMHC
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 105 E MANNING ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-4309
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Country | US
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Telephone | 401-383-7647
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Fax |
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Provider Business Mailing Address
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Address Line | 23 AVON RD
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City | CRANSTON
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State | RI
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Zip | 02905-1136
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Country | US
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Telephone | 401-781-2466
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MHC00039
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License Number State | RI
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