Provider Demographics
NPI:1851511588
Name:INTERFAITH COUNSELING CENTER
Entity Type:Organization
Organization Name:INTERFAITH COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-461-5234
Mailing Address - Street 1:1520 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-2811
Mailing Address - Country:US
Mailing Address - Phone:401-461-5234
Mailing Address - Fax:401-461-5233
Practice Address - Street 1:1520 BROAD ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2811
Practice Address - Country:US
Practice Address - Phone:401-461-5234
Practice Address - Fax:401-461-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health