Provider Demographics
NPI:1750930103
Name:INTEGRATED PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:INTEGRATED PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFFI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:401-527-8475
Mailing Address - Street 1:333 SCHOOL ST STE 109
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5335
Mailing Address - Country:US
Mailing Address - Phone:401-406-4586
Mailing Address - Fax:401-406-4460
Practice Address - Street 1:333 SCHOOL ST STE 109
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5335
Practice Address - Country:US
Practice Address - Phone:401-406-4586
Practice Address - Fax:401-406-4460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty