MEDICARE: RETURN 2U PSYCHOTHERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1306520051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RETURN 2U PSYCHOTHERAPY, LLC

Provider Business Mailing Address
First Line	:	62 MARION AVE S
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02905-3806
Country	:	US
Telephone Number	:	508-469-0748
Fax Number	:

Provider Business Practice Location Address
First Line	:	287 WASHINGTON ST STE 6
Second Line	:
City	:	S ATTLEBORO
State	:	MA
Zip	:	02703-5524
Country	:	US
Telephone Number	:	508-469-0748
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	WILLIAM BROOKS SAUL
Credential	:	LICSW
Telephone Number	:	508-469-0748

Provider Enumeration Date	:	06/13/2023
Last Update Date	:	06/13/2023

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