Provider Demographics
NPI:1578052056
Name:THE CENTER FOR SOCIAL EMOTIONAL ENRICHMENT, LLC
Entity Type:Organization
Organization Name:THE CENTER FOR SOCIAL EMOTIONAL ENRICHMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMPKOWSKI-MANN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:401-692-9390
Mailing Address - Street 1:18 CURRAN RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-8002
Mailing Address - Country:US
Mailing Address - Phone:401-692-9390
Mailing Address - Fax:
Practice Address - Street 1:15 MARTIN ST UNIT 3
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-5361
Practice Address - Country:US
Practice Address - Phone:401-533-7213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health