Emdr & Somatic Psychotherapies of Rhode Island

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EMDR & SOMATIC PSYCHOTHERAPIES OF RHODE ISLAND

Practice address

1 Richmond SQ Ste 333C
Providence, RI 02906-5139

Phone

(401) 441-5834

NPI assigned

Oct 26, 2021

Last updated

Oct 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Madrone PhoenixNPI 1548779366

Title

Owner

Phone

(401) 297-0692

Specialties & licenses 1

Addresses

Tax ID family

Emdr Somatic Psychotherapies of Rhode Island2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Emdr & Somatic Psychotherapies of Rhode Island

  • Clinical Social Worker
  • Providence, RI
  • NPI 1912598046
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Madrone Bayan Phoenix, LICSW

  • Clinical Social Worker
  • Providence, RI
  • NPI 1548779366
  Authorized official Same address or phone

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1457015463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "KINGSTON",
            "state": "RI",
            "postal_code": "028810005",
            "telephone_number": "401-441-5834",
            "fax_number": "401-208-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHMOND SQ STE 333C",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065139",
            "telephone_number": "401-441-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMDR & SOMATIC PSYCHOTHERAPIES OF RHODE ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "PHOENIX",
        "authorized_official_first_name": "MADRONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-297-0692"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dalal Hassan Elsori, M.D.
• Michael J Eltz, PH.D.
• Susan P Emaus, PA C
• Embrace Healing Psychiatric Services, LLC
• Embracing Tomorrow Therapeutic Services LLC
• Emdr & Somatic Psychotherapies of Rhode Island
• Emergency Medicine Physicians of Providence County, LLC
• Emerging Energy Acupuncture, LLC
• Christina Maria Emerson
• Douglas F Emery, MD

• Clinical Social Worker in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.