Colleen Madden Wham

Individual provider Active NPI Professional Counselor · Providence, RI

NPI 1629534243 · NPPES record last updated Feb 19, 2019

Key facts

NPI
1629534243
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
PC006657 (PA)
Practice address
188 Valley St Ste 201
Providence, RI 02909-2468
Phone
(215) 285-0445
NPI assigned
Feb 19, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PC006657PAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC006657 PA Yes

Addresses

Primary practice location

188 Valley St Ste 201
Providence, RI 02909-2468

Mailing address

188 Valley St Ste 201
Providence, RI 02909-2468
Phone (215) 285-0445

Other providers in Providence, RI

All providers in Providence, RI · Professional Counselor in Rhode Island

Sources for this page

Verify at the official NPI Registry.