Provider Demographics
NPI:1255843264
Name:LAPORTE, FLORENCE (MS LADC CCS)
Entity Type:Individual
Prefix:MS
First Name:FLORENCE
Middle Name:
Last Name:LAPORTE
Suffix:
Gender:F
Credentials:MS LADC CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 POND STREET
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860
Mailing Address - Country:US
Mailing Address - Phone:401-727-1287
Mailing Address - Fax:401-727-1289
Practice Address - Street 1:82 POND ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4462
Practice Address - Country:US
Practice Address - Phone:401-727-1287
Practice Address - Fax:401-727-1289
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001145101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI601100465Medicaid