Wellformed AI

NPI 1477959849 · live from the CMS NPI Registry

Behavioral Health Solutions

Psychologist, Clinical in Providence, RI. National Provider Identifier 1477959849, active.

NPI record

NPI1477959849 Type 2 · organization
StatusActive
Primary specialtyPsychologist, Clinical 103TC0700X
Practice location62 Gesler St, Providence, RI 02909
Practice phone401-831-2794
EnumeratedNovember 13, 2014
Last updatedNovember 13, 2014
Authorized officialMichael Eltz, Co-Director

Taxonomies and licenses

TaxonomyCodeLicense
Psychologist, Clinical primary103TC0700XPS00748 (RI)

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.