Provider Demographics
NPI:1841030046
Name:SPILLANE, NICHEA S (PHD)
Entity type:Individual
Prefix:DR
First Name:NICHEA
Middle Name:S
Last Name:SPILLANE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 APPLE HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02921-2103
Mailing Address - Country:US
Mailing Address - Phone:859-321-9918
Mailing Address - Fax:
Practice Address - Street 1:51 APPLE HOUSE DR
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02921-2103
Practice Address - Country:US
Practice Address - Phone:859-321-9918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01823103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty