Provider Demographics
NPI:1619376712
Name:FRANDY MATHIEU
Entity Type:Organization
Organization Name:FRANDY MATHIEU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIEU
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:401-658-6922
Mailing Address - Street 1:56 COLUMBUS AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4516
Mailing Address - Country:US
Mailing Address - Phone:401-658-6922
Mailing Address - Fax:
Practice Address - Street 1:520 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-2769
Practice Address - Country:US
Practice Address - Phone:617-989-9499
Practice Address - Fax:617-445-2672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health