Provider Demographics
NPI:1659549764
Name:KYRIAKAKIS, KERRI LYNN (LCDP)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:LYNN
Last Name:KYRIAKAKIS
Suffix:
Gender:F
Credentials:LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 HOLBURN AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5806
Mailing Address - Country:US
Mailing Address - Phone:401-383-6029
Mailing Address - Fax:401-615-9540
Practice Address - Street 1:1 JAMES P. MURPHY HIGHWAY
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893
Practice Address - Country:US
Practice Address - Phone:401-615-0648
Practice Address - Fax:401-615-9540
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILCDP 00407101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health