Provider Demographics
NPI:1851453385
Name:CRONIN, JOSEPHINE M (LCDP)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:M
Last Name:CRONIN
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 1:8 MARTINGALE LN
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-4223
Mailing Address - Country:US
Mailing Address - Phone:401-792-8894
Mailing Address - Fax:
Practice Address - Street 1:127 JOHNNY CAKE HILL RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5674
Practice Address - Country:US
Practice Address - Phone:401-846-1213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILCDP00296101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIJC53539Medicaid