Provider Demographics
NPI:1295189074
Name:BRISSETTE, NORMAND ROBERT (CADC, LCDP)
Entity type:Individual
Prefix:MR
First Name:NORMAND
Middle Name:ROBERT
Last Name:BRISSETTE
Suffix:
Gender:M
Credentials:CADC, LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 WATERMAN ST.
Mailing Address - Street 2:SUITE 10
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1329
Mailing Address - Country:US
Mailing Address - Phone:401-214-5923
Mailing Address - Fax:401-414-0707
Practice Address - Street 1:154 WATERMAN ST.
Practice Address - Street 2:SUITE 10
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-1329
Practice Address - Country:US
Practice Address - Phone:401-214-5923
Practice Address - Fax:401-414-0707
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00646101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)