Provider Demographics
NPI:1578248357
Name:ICAN, LLC
Entity Type:Organization
Organization Name:ICAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORLONEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNS, CNP
Authorized Official - Phone:401-323-6237
Mailing Address - Street 1:26 NAPLES AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-1222
Mailing Address - Country:US
Mailing Address - Phone:401-487-8298
Mailing Address - Fax:401-274-0923
Practice Address - Street 1:26 NAPLES AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-1222
Practice Address - Country:US
Practice Address - Phone:401-487-8298
Practice Address - Fax:401-274-0923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Multi-Specialty
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, GeropsychiatricGroup - Multi-Specialty