Provider Demographics
NPI:1275774010
Name:DOVE, DAVID CLIFTON (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CLIFTON
Last Name:DOVE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CHACE AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-1337
Mailing Address - Country:US
Mailing Address - Phone:401-533-3015
Mailing Address - Fax:888-867-2945
Practice Address - Street 1:194 WATERMAN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4015
Practice Address - Country:US
Practice Address - Phone:401-533-3015
Practice Address - Fax:888-867-2945
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01064103TB0200X, 103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily