Stefanie Briganti, ACDP
Individual provider Active NPI Counselor · Pawtucket, RI
NPI 1104132398 · NPPES record last updated Jun 12, 2014
Key facts
- NPI
- 1104132398
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 101 Bacon St
Pawtucket, RI 02860-5542 - Phone
- (401) 724-8400
- Fax
- (401) 722-5280
- NPI assigned
- Aug 25, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACDP167310 | RI | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ACDP167310 | RI | |
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
101 Bacon St
Pawtucket, RI 02860-5542
Mailing address
101 Bacon St
Pawtucket, RI 02860-5542
Phone (401) 724-8400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GH571354 | Medicaid | RI |
Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.