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General NPI Number Information
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NPI Number | 1932706199
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Entity Type | Organization
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Legal Business Name | KDR COUNSELING, LLC
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 111 JOHN ST
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City | LINCOLN
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State | RI
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Zip | 02865-1748
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Country | US
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Telephone | 401-537-8216
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MOWRY AVE
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City | NORTH SMITHFIELD
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State | RI
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Zip | 02896-7110
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Country | US
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Telephone | 401-323-4244
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | KIMBERLY DIORIO-ROONEY
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Credential | LICSW
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Telephone | 401-323-4244
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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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