Provider Demographics
NPI:1881737658
Name:SPAULDING, VIRGINIA MARY (PHD)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:MARY
Last Name:SPAULDING
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 1:54 MALBONE RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-1746
Mailing Address - Country:US
Mailing Address - Phone:401-845-9621
Mailing Address - Fax:
Practice Address - Street 1:54 MALBONE RD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-1746
Practice Address - Country:US
Practice Address - Phone:401-845-9621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI637103TC1900X
MA7375103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1023130Medicare UPIN
RI6149870Medicare UPIN
RI689007863Medicare PIN
RI21583-1Medicare UPIN
RI080449Medicare UPIN
RI244110000Medicare UPIN