MEDICARE: NANCY SERABIAN

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1992161525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NANCY SERABIAN

Provider Business Mailing Address
First Line	:	1804 MINERAL SPRING AVE
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-7648
Country	:	US
Telephone Number	:	401-354-5600
Fax Number	:	401-354-5601

Provider Business Practice Location Address
First Line	:	1804 MINERAL SPRING AVE
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-7648
Country	:	US
Telephone Number	:	401-354-5600
Fax Number	:	401-354-5601

Authorized Official
Title or Position	:	OWNER
Name	:	NANCY SERABIAN
Credential	:	APRN
Telephone Number	:	401-354-5600

Provider Enumeration Date	:	01/12/2016
Last Update Date	:	01/12/2016

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Directions to “NANCY SERABIAN ” Practice Location

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