Organization Active NPI

Mental Health Consultant Service

  • Adult Mental Health Clinic/Center
  • Providence, RI
National Provider Identifier
1104332725
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MENTAL HEALTH CONSULTANT SERVICE
Practice address
400 Reservoir Ave Ste 2G
Providence, RI 02907-3594
Phone
(401) 632-4470
Fax
(401) 632-4470
NPI assigned
Dec 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cristiana Morena RitwikNPI 1932199858
Title
Owner
Phone
(401) 632-4470

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

400 Reservoir Ave Ste 2G
Providence, RI 02907-3594

Mailing address

400 Reservoir Ave Ste 2G
Providence, RI 02907-3594
Phone (401) 632-4470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180320002535 RI Part B Supplier - Clinic/Group Practice 5597027144 Receives reassigned benefits from 1 practitioner
Practice locations: Providence, RI

National Provider Directory

National Provider Directory

Locations

400 Reservoir Ave
Ste 2G
Providence, RI 02907
Phone (401) 203-5011

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1104332725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RESERVOIR AVE STE 2G",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029073594",
            "telephone_number": "401-632-4470",
            "fax_number": "401-632-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RESERVOIR AVE STE 2G",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029073594",
            "telephone_number": "401-632-4470",
            "fax_number": "401-632-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH CONSULTANT SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "RITWIK",
        "authorized_official_first_name": "CRISTIANA",
        "authorized_official_middle_name": "MORENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-632-4470"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.