Provider Demographics
NPI:1760593297
Name:TIVERTON COUNSELING SERVICES
Entity Type:Organization
Organization Name:TIVERTON COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:DUGGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:1401-692-6707
Mailing Address - Street 1:223B JOHN DYER RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE COMPTON
Mailing Address - State:RI
Mailing Address - Zip Code:02837-1920
Mailing Address - Country:US
Mailing Address - Phone:401-692-6707
Mailing Address - Fax:
Practice Address - Street 1:1061 FISH RD
Practice Address - Street 2:
Practice Address - City:TIVERTON
Practice Address - State:RI
Practice Address - Zip Code:02878-3103
Practice Address - Country:US
Practice Address - Phone:401-692-6707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW017071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty