Innovative Therapeutics of Rhode Island LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN01440 Issued in RI

Legal business name

INNOVATIVE THERAPEUTICS OF RHODE ISLAND LLC

Practice address

316 Willett Ave
Riverside, RI 02915-2511

Phone

(401) 270-2468

Fax

(781) 964-9446

NPI assigned

Oct 25, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Wendy Carlson, PMHNP-BCNPI 1891158564

Title

Owner

Phone

(781) 964-9446

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Wendy Marie Carlson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Berkley, MA
  • NPI 1891158564
  NPD (past) Authorized official

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1861944969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 WILLETT AVE",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152511",
            "telephone_number": "401-270-2468",
            "fax_number": "781-964-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 WILLETT AVE",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152511",
            "telephone_number": "401-270-2468",
            "fax_number": "781-964-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE THERAPEUTICS OF RHODE ISLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-964-9446",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN01440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Marie Iaciofano, LICSW
• Noor Ibrahim, LICSW
• Infusion Resource, LLC
• Infusion Resource, LLC
• Infusion Services of Northern Massachusetts Inc
• Nicole M. Interlini, LMHC
• Island Health and Rehab LLC
• Albert Jacavone, RN
• Kim Jardin, RN
• Jennifer W. Jencks, PH.D.

• Psychiatric/Mental Health Nurse Practitioner in Riverside, RI
• Providers in Riverside, RI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.