Provider Demographics
NPI:1720491871
Name:PSYCHOTHERAPY PRACTICE OF NORTH KINGSTOWN
Entity Type:Organization
Organization Name:PSYCHOTHERAPY PRACTICE OF NORTH KINGSTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUARTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:401-921-5400
Mailing Address - Street 1:1130 TEN ROD RD
Mailing Address - Street 2:BUILDING E, SUITE 101
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4161
Mailing Address - Country:US
Mailing Address - Phone:401-921-5400
Mailing Address - Fax:401-921-5402
Practice Address - Street 1:1130 TEN ROD RD
Practice Address - Street 2:BUILDING E, SUITE 101
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4161
Practice Address - Country:US
Practice Address - Phone:401-921-5400
Practice Address - Fax:401-921-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty