Jesus Berrio
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Providence, RI
NPI 1891209045 · NPPES record last updated Nov 27, 2017
Key facts
- NPI
- 1891209045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CDP00716 (RI)
- Practice address
- 530 N Main St
Providence, RI 02904-5762 - Phone
- (401) 276-4100
- NPI assigned
- Nov 27, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDP00716 | RI | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDP00716 | RI | Yes |
Addresses
Primary practice location
530 N Main St
Providence, RI 02904-5762
Mailing address
530 N Main St
Providence, RI 02904-5762
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YA0400X | Medicaid | RI |
Other providers in Providence, RI
- Emily Bernstein
- Ida M. Bernstein
- Marcy Ellen Bernstein
- Virginia Bernstein
- Erika Berrio
- Julio Berroa
- Yudelka Berroa
- Arlene H. Berrol
- Ross Berry
- Joseph Chaffin Berryhill
All providers in Providence, RI · Addiction (Substance Use Disorder) Counselor in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.