Provider Demographics
NPI:1285025437
Name:ANCHOR MEMORY CLINIC, INC
Entity Type:Organization
Organization Name:ANCHOR MEMORY CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-475-9979
Mailing Address - Street 1:652 GEORGE WASHINGTON HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4330
Mailing Address - Country:US
Mailing Address - Phone:401-475-9979
Mailing Address - Fax:401-475-9917
Practice Address - Street 1:652 GEORGE WASHINGTON HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4330
Practice Address - Country:US
Practice Address - Phone:401-475-9979
Practice Address - Fax:401-475-9917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00565101YM0800X
RIMHC00469101YM0800X
RIMHC00660101YM0800X
RIPS01358103G00000X
RIISW020061041C0700X
RIISW017511041C0700X
RIISW018611041C0700X
RIMFT00161106H00000X
RIMFT00094106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty