Provider Demographics
NPI:1437329125
Name:COUNSELING & PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:COUNSELING & PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARYBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISSETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-751-5575
Mailing Address - Street 1:203 GOVERNOR ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3221
Mailing Address - Country:US
Mailing Address - Phone:401-751-5575
Mailing Address - Fax:
Practice Address - Street 1:203 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3221
Practice Address - Country:US
Practice Address - Phone:401-751-5575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health