THE PROVIDENCE CENTER INC (NPI# 1104847946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104847946 |
| Entity Type | Organization |
| Organization Name | THE PROVIDENCE CENTER INC |
| Practice Address |
528 North Main Street Providence RI 02904-5759 |
| Mailing Address |
528 N Main St Providence RI 02904-5757 |
| Practice Telephone | 4015280123 |
| Practice Fax Number | 4015280124 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-01-22 |
| Authorized Official Name | DONNA RICHARD (DIRECTOR OF PRACTICE ADMINISTRATION) |
| Authorized Official Telephone | 4015280140 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 163W00000X | Registered Nurse | Nursing Service Providers | ||
| N | 175T00000X | Peer Specialist | Other Service Providers | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 207SG0205X |
Medical Genetics Specialization: Ph.D. Medical Genetics |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 251S00000X | Community/Behavioral Health | 631 | RI | Agencies |
| N | 364S00000X | Clinical Nurse Specialist | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | BLUE CHIP | 410282 | 01 |
| RI | BLUE CROSS | 23770 | 01 |
| RI | PC02213 | 05 | |
| RI | PC11826 | 05 | |
| RI | BEACON | 1021730 | 01 |
| RI | UNITED BEHAVIORAL HEALTH | 50-64724 | 01 |
| RI | PC02214 | 05 | |
| RI | DCYF-MEDICAID | PC07340 | 01 |
| Street Address |
528 NORTH MAIN STREET |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02904-5759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144792383 | Lifespan Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 180 Corliss Street, Suite A, Providence, RI 02904 | 2018-12-28 |
| 1780168229 | Beth M. Kalunian | Social Worker | 480 Charles Street, Providence, RI 02904 | 2018-09-20 |
| 1588161608 | Michael P. Johnson, Md, Inc | Internal Medicine | 148 W River St Ste 22b, Providence, RI 02904 | 2018-04-06 |
| 1780045948 | Fred Saccoccio | Pharmacist | 15 Smithfield Road, No Providence, RI 02904 | 2016-03-16 |
| 1699148999 | Latin Adult Day Health Care Center | Clinic/Center | 665 Charles Street, Providence, RI 02904 | 2015-11-09 |
| 1144639956 | Dina P Toolin | Occupational Therapist | 195 Collyer St. 3rd Floor, University Medical Center/miriam Hospital Outpatient, Providence, RI 02904 | 2014-08-06 |
| 1801208798 | Seth Clark | Internal Medicine | 200 Corliss St, Providence, RI 02904 | 2014-05-27 |
| 1134554645 | Molly Elizabeth Smith | Physical Therapist | 1405 Douglas Ave, North Providence, RI 02904 | 2013-09-04 |
| 1336408723 | Emad Awa | Pediatrics | 1 Randall Sq Ste 404, Providence, RI 02904 | 2012-05-07 |
| 1598036790 | Joseph F. Osmanski, Od, Inc | Optometrist | 1971 Mineral Spring Avenue, N. Providence, RI 02904 | 2012-01-19 |
| Find all providers in zip 02904 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002006 | East Side Psychotherapy, Inc. | Community/Behavioral Health | 205 Waterman St # 201, Providence, RI 02906-4313 | 2020-10-28 |
| 1336677541 | Theadore Perry | Community/Behavioral Health | 251 Indiana Ave, Providence, RI 02905-2822 | 2017-06-01 |
| 1255863387 | Ludmyr Merlain | Community/Behavioral Health | 52 Felix St, Providence, RI 02908-4837 | 2017-03-29 |
| 1922478056 | Clear Recovery of Cache Valley | Community/Behavioral Health | 277 N Spring Creek Pkwy, Providence, UT 84332-9775 | 2015-10-01 |
| 1992053896 | Harbor House | Community/Behavioral Health | 12 Bassett St, Providence, RI 02903-4206 | 2012-08-27 |
| 1578859179 | Whitmarsh Corporation | Community/Behavioral Health | 1055 N Main St, Providence, RI 02904-5718 | 2011-06-22 |
| 1528352424 | Capital City | Community/Behavioral Health | 25 Danforth St, Providence, RI 02908-3610 | 2011-06-08 |
| 1295028272 | The Genesis Center | Community/Behavioral Health | 620 Potters Ave, Providence, RI 02907-2931 | 2011-05-24 |
| 1568608461 | Adoption Rhode Island | Community/Behavioral Health | 2 Bradford St, Providence, RI 02903-1092 | 2008-12-23 |
| 1457549578 | Nickerson Community Center | Community/Behavioral Health | 97 Delaine St, Providence, RI 02909-2726 | 2007-10-15 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02904 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.