Provider Demographics
NPI:1356367916
Name:D'ALUISIO-COYKENDALL, LAURA SUSAN II (LMHC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:SUSAN
Last Name:D'ALUISIO-COYKENDALL
Suffix:II
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 1:317 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2209
Mailing Address - Country:US
Mailing Address - Phone:401-935-2645
Mailing Address - Fax:
Practice Address - Street 1:317 HOPE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2209
Practice Address - Country:US
Practice Address - Phone:401-935-2645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILD47273Medicaid