Active NPI
Elizabeth Ann Coderre, LMHC
- Mental Health Counselor
- Providence, RI
National Provider Identifier
1164552725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHC00119
- Practice address
- 335 Angell Street
Providence, RI 02906-3245 - Phone
- (401) 487-0024
- Fax
- (401) 765-3321
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHC00119 | RI | Primary |
Addresses
Primary practice location
335 Angell Street
Providence, RI 02906-3245
Mailing address
2 Birch Hill Avenue
North Smithfield, RI 02896-7402
Phone (401) 765-4519
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHC00119 | RI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164552725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 BIRCH HILL AVENUE",
"city": "NORTH SMITHFIELD",
"state": "RI",
"postal_code": "028967402",
"telephone_number": "401-765-4519",
"fax_number": "401-765-3321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 ANGELL STREET",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029063245",
"telephone_number": "401-487-0024",
"fax_number": "401-765-3321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CODERRE",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "RI",
"license": "MHC00119",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.