Provider Demographics
NPI:1336638303
Name:RHODE ISLAND COUNSELING ASSOCIATES LLC
Entity Type:Organization
Organization Name:RHODE ISLAND COUNSELING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:HILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-259-0340
Mailing Address - Street 1:1150 RESERVOIR AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6043
Mailing Address - Country:US
Mailing Address - Phone:401-259-0340
Mailing Address - Fax:
Practice Address - Street 1:1150 RESERVOIR AVE STE 203
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6043
Practice Address - Country:US
Practice Address - Phone:401-259-0340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-05
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00757101YM0800X
101YM0800X, 104100000X, 2084N0400X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty