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General NPI Number Information
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NPI Number | 1952519787
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Entity Type | Organization
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Legal Business Name | FAMILY TREE COUNSELING INC.
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 50 KEITH AVE
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City | CRANSTON
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State | RI
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Zip | 02910-5724
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Country | US
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Telephone | 401-785-0608
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Fax | 401-785-6042
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Provider Business Mailing Address
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Address Line | 50 KEITH AVE
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City | CRANSTON
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State | RI
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Zip | 02910-5724
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Country | US
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Telephone | 401-785-0608
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Fax | 401-785-6042
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Authorized Official
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Title or Position | SOCIAL WORKER OWNER
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Name | ANDY BARNES
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Credential | MSW, LICSW
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Telephone | 401-785-0608
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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 | ISW 483
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License Number State | RI
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