Provider Demographics
NPI:1235562646
Name:NINIGRET COUNSELING SERVICES
Entity Type:Organization
Organization Name:NINIGRET COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-364-3255
Mailing Address - Street 1:PO BOX 1442
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02813-0918
Mailing Address - Country:US
Mailing Address - Phone:401-364-3255
Mailing Address - Fax:
Practice Address - Street 1:23 NORTH RD
Practice Address - Street 2:LILY PAD PROFESSIONAL CENTER
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-8132
Practice Address - Country:US
Practice Address - Phone:401-364-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW02227251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health