Organization Active NPI

Emdr & Somatic Psychotherapies of Rhode Island

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1457015463
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
Madrone Phoenix
Title
Owner
Phone
(401) 297-0692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

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

Mailing address

PO Box 5
Kingston, RI 02881-0005
Phone (401) 441-5834

National Provider Directory

National Provider Directory
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.

Locations

1 Richmond Sq
Ste 333C
Providence, RI 02906
Phone (401) 441-5834

35 South County Commons Way
Ste D8D
Wakefield, RI 02879
Phone (401) 218-1317

NPI Registry JSON

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": []
}

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 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.