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General NPI Number Information
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NPI Number | 1932816980
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Entity Type | Organization
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Legal Business Name | BAYBERRY PSYCHOLOGY & CONSULTING LLC
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 291 WATERMAN ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-5130
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Country | US
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Telephone | 401-426-4239
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Fax |
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Provider Business Mailing Address
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Address Line | 9 APPIAN WAY
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City | BARRINGTON
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State | RI
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Zip | 02806-1821
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Country | US
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Telephone | 901-490-9700
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. THOMAS S MCCANN
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Credential | PHD
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Telephone | 901-490-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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