Provider Demographics
NPI:1407967169
Name:ESPOSITO-SMYTHERS, CHRISTIANNE (PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTIANNE
Middle Name:
Last Name:ESPOSITO-SMYTHERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHRISTIANNE
Other - Middle Name:
Other - Last Name:ESPOSITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:BROWN UNIVERSITY
Mailing Address - Street 2:CENTER FOR ALCOHOL & ADDICTION, BOX G-BH
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02912-0001
Mailing Address - Country:US
Mailing Address - Phone:401-444-1898
Mailing Address - Fax:401-444-1850
Practice Address - Street 1:1011 VETERANS MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-5061
Practice Address - Country:US
Practice Address - Phone:401-432-1000
Practice Address - Fax:401-432-1500
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00822103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICE61484Medicaid
RI31308-1OtherBLUE CROSS
RI413290OtherBLUE CHIP