Provider Demographics
NPI:1912241811
Name:KM COUNSELING AND CONSULTANT SERVICES INC
Entity Type:Organization
Organization Name:KM COUNSELING AND CONSULTANT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEDEIROS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:401-658-6448
Mailing Address - Street 1:10 NATE WHIPPLE HWY
Mailing Address - Street 2:BUD BLDG. 2ND FLOOR
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1415
Mailing Address - Country:US
Mailing Address - Phone:401-658-6448
Mailing Address - Fax:401-658-0100
Practice Address - Street 1:10 NATE WHIPPLE HWY
Practice Address - Street 2:BUD BLDG. 2ND FLOOR
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-1415
Practice Address - Country:US
Practice Address - Phone:401-658-6448
Practice Address - Fax:401-658-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00198251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health