Nickerson Community Center

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

NICKERSON COMMUNITY CENTER

Practice address

97 Delaine St
Providence, RI 02909-2726

Phone

(401) 383-5672

NPI assigned

Oct 15, 2007

Organization subpart

No

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

Authorized official

Name

Lisa D'Ambra

Title

Executive Director

Phone

(401) 351-2241

Specialties & licenses 2

Addresses

Practitioners 1

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

• Steven K Diehl, PHD

  • Psychologist
  • Middletown, RI
  • NPI 1215988175
  NPD (past)

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1457549578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 DELAINE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029092728",
            "telephone_number": "401-351-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 DELAINE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029092726",
            "telephone_number": "401-383-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICKERSON COMMUNITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "D'AMBRA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "401-351-2241"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliza Nichols, MSPAS, PA-C
• Hannah Mari Nichols
• Kelsey A Nichols, LCSW
• Patrick A Nichols, RN
• Linda Nici, M.D.
• Christina Nickerson
• Rene Nicoletti, LICSW
• Duyu Nie, M.D., PH.D
• Kate Marie Nielsen, PH.D.
• Amethys Nieves, LCSW

• Emotionally Disturbed Childrens' Residential Treatment Facility in Providence, RI
• Providers in Providence, RI by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.

Verify at the official NPI Registry.