Provider Demographics
NPI:1689944472
Name:SARAIVA, MARY ANGELA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARY ANGELA
Middle Name:
Last Name:SARAIVA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 POST RD
Mailing Address - Street 2:UNIT 303
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-1528
Mailing Address - Country:US
Mailing Address - Phone:401-497-7404
Mailing Address - Fax:
Practice Address - Street 1:900 RESERVOIR AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4453
Practice Address - Country:US
Practice Address - Phone:401-497-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI00429OtherLMHC, LICENSED MENTAL HEALTH COUNSELOR