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General NPI Number Information
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NPI Number | 1942541750
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL COUNSELING ASSOCIATES, INC
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 5840 POST RD
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City | EAST GREENWICH
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State | RI
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Zip | 02818-2140
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Country | US
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Telephone | 401-499-1631
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Fax |
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Provider Business Mailing Address
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Address Line | 48 SURF AVE
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City | WARWICK
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State | RI
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Zip | 02889-6121
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Country | US
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Telephone | 401-499-1631
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KIMBERLY LEANDRE
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Credential | LMHC, CAGS
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Telephone | 401-499-1631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MHC00412
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License Number State | RI
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