Provider Demographics
NPI:1609632140
Name:SOUZA, MIKAYLA (LMHCA)
Entity Type:Individual
Prefix:MRS
First Name:MIKAYLA
Middle Name:
Last Name:SOUZA
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:MRS
Other - First Name:MIKAYLA
Other - Middle Name:
Other - Last Name:CABRAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHCA
Mailing Address - Street 1:3 APPLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-1301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1524 ATWOOD AVE STE 115
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-426-5646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health