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General NPI Number Information
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NPI Number | 1982118295
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Entity Type | Organization
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Legal Business Name | CANAAN PSYCHOTHERAPY INC,
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Dates
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Enumeration Date | 11/22/2017
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 828 TOLL GATE RD
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City | WARWICK
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State | RI
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Zip | 02886-2721
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Country | US
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Telephone | 401-385-3936
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Fax | 401-397-3488
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Provider Business Mailing Address
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Address Line | 140 LAKE DR
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City | WEST GREENWICH
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State | RI
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Zip | 02817-1563
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Country | US
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Telephone | 401-338-3782
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Fax | 401-397-3488
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CYNTHIA P LONGWAY
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Credential | APRN CNS
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Telephone | 401-338-3782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | CAPRN00031
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License Number State | RI
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