KIM MARIE MEDEIROS (NPI# 1235230640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235230640 |
| Entity Type | Individual |
| Full Name | KIM MARIE MEDEIROS |
| Credential | LMHC |
| Practice Address |
623 Atwells Ave Providence RI 02909-7403 |
| Mailing Address |
134 Leigh Rd Cumberland RI 02864-4009 |
| Practice Telephone | 4012737103 |
| Practice Fax Number | 4014214608 |
| Mailing Telephone | 4014752413 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
00198 | RI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | BLUESHIELD | 31256-1 | 01 |
| RI | BLUECHIP COORDINATED HEAL | 413222 | 01 |
| Street Address |
623 ATWELLS AVE |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02909-7403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689287039 | Sara Hafeez | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2020-08-26 |
| 1144846478 | Brett Zerbinopoulos | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2020-06-23 |
| 1609438902 | Brittney Eileen Schieber | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2019-07-08 |
| 1578129078 | Hyder Jamal Almosawy | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2019-05-10 |
| 1881172419 | Justin Roberts | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2018-08-06 |
| 1811475536 | Zachary Gene Walburg | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2018-08-03 |
| 1366920084 | Joyce Nidal Rached | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2018-08-03 |
| 1407332166 | Julia Marie Gangloff | Audiologist | 623 Atwells Ave, Providence, RI 02909-7403 | 2018-07-16 |
| 1780107607 | Sarah Wise | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2017-07-23 |
| 1467805374 | Christopher Briody | Audiologist | 623 Atwells Ave, Providence, RI 02909-7403 | 2016-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578021754 | Roberta Bellas Portugal | Registered Nurse | Behave Care, 188 Valley St, Providence, RI 02909 | 2019-03-07 |
| 1912137324 | Catherine Elaine Tuttle | Social Worker | 623 Atwells Avenue, Suite 201, Providence, RI 02909 | 2009-07-20 |
| 1477736452 | City Dental, LLC | Dentist | 314f Pocasset Avenue, Providence, RI 02909 | 2007-12-12 |
| 1245449651 | Walter R. Vandyck | Occupational Therapist | Springfield Middle School, Providene School Department, 152 Springfield St, Providence, RI 02909 | 2007-05-22 |
| 1780805283 | Marcel A Trisvan | Counselor | Codac Providence, 349 Huntington Ave, Providence, RI 02909 | 2007-05-01 |
| 1215153945 | Codac Inc | Peer Specialist | 349 Huntington Ave, Codac Providence, Providence, RI 02909 | 2007-04-18 |
| 1316076342 | Mulak Chiropractic Center Inc | Chiropractor | 411 Broadway, Providence, RI 02909 | 2007-03-05 |
| 1710042742 | Michael Antonio Pensa | Chiropractor | 45 Eagle St Bld J Unit 100, Providence, RI 02909 | 2006-12-27 |
| 1780768234 | Providence Community Action | Case Management | 662 Hartford Avenue, Providence, RI 02909 | 2006-10-24 |
| 1881629608 | Cora Brigid Mayer | Counselor | 623 Atwells Ave., Communities for People, Inc., Providence, RI 02909 | 2006-07-11 |
| Find all providers in zip 02909 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932738416 | Rhea Bhatia | Counselor | 219 Leah St Unit 2, Providence, RI 02908-3907 | 2020-04-06 |
| 1568098721 | Roisin Mcgettigan | Counselor | 365 Hope St, Providence, RI 02906-1633 | 2020-03-19 |
| 1962049932 | Wholelife Family Wellness Clinic of Providence Pllc | Counselor | 169 N Gateway Dr. Suite 170, Providence, UT 84332 | 2019-12-09 |
| 1679117675 | Abbey Seabury Chrupcala | Counselor | 382 Thayer St, Providence, RI 02906-1558 | 2019-11-01 |
| 1205392891 | Sara De Carvalho | Counselor | 21 Pratt St # 5, Providence, RI 02906-1424 | 2019-02-19 |
| 1376008078 | Rebecca Zub | Counselor | 58 Taft Ave Apt 9, Providence, RI 02906-3473 | 2019-02-06 |
| 1821509944 | Hologram Central | Counselor | 44 Barbara St Unit 1, Providence, RI 02909-5110 | 2017-10-16 |
| 1497273932 | Ashley Jasmine Williams | Counselor | 131 Ledge St, Providence, RI 02904-1532 | 2017-09-05 |
| 1912448481 | Catherine Allard | Counselor | 225 Carpenter St, Providence, RI 02903-3044 | 2017-03-16 |
| 1649711144 | Kerri Peterson Weaver | Counselor | 400 Reservoir Ave Ste Llo, Providence, RI 02907-3595 | 2017-03-16 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02909 |
Please comment or provide details below to improve the information on KIM MARIE MEDEIROS.
| 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.