Provider Demographics
NPI:1851338180
Name:CHEVALIER, CONCETTA CAROL (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CONCETTA
Middle Name:CAROL
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 JULIA DR
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-1117
Mailing Address - Country:US
Mailing Address - Phone:401-231-4220
Mailing Address - Fax:
Practice Address - Street 1:500 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1362
Practice Address - Country:US
Practice Address - Phone:401-737-0820
Practice Address - Fax:401-737-0830
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00049106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1023290OtherBEACON HEALTH
RIFM49368Medicaid
RI411282OtherBLUE CHIP
RIUNITED HEALTHOther6238130
RI26905-8OtherR.I. BLUE CROSS BLUE SHIE