Provider Demographics
NPI:1184825192
Name:VOTA, MAURA CARROLL (LMHC)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:CARROLL
Last Name:VOTA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RICHMOND SQ STE 103K
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5166
Mailing Address - Country:US
Mailing Address - Phone:602-339-8209
Mailing Address - Fax:401-400-8172
Practice Address - Street 1:1 RICHMOND SQ STE 103K
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5166
Practice Address - Country:US
Practice Address - Phone:602-339-8209
Practice Address - Fax:401-400-8172
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00460101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMHC00460OtherPROFESSIONAL LICENSE