| Mr Joseph John Tetreault Jr, MS | |
|
593 Eddy St, Providence, RI 02903-4923 | |
| (401) 444-4900 | |
| Not Available |
| Full Name | Mr Joseph John Tetreault Jr |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 593 Eddy St, Providence, Rhode Island |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275120594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MHC01508 (Rhode Island) | Primary |
| Entity Name | Gateway Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821078932 PECOS PAC ID: 7719874908 Enrollment ID: O20040302001066 |
| Entity Name | Emma Pendleton Bradley Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578768867 PECOS PAC ID: 3870527526 Enrollment ID: O20050921001082 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Joseph John Tetreault Jr, MS 117 Ellenfield St Ste 101, Providence, RI 02905-4541 Ph: () - | Mr Joseph John Tetreault Jr, MS 593 Eddy St, Providence, RI 02903-4923 Ph: (401) 444-4900 |
Olivia Meunier, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 530 N Main St, Providence, RI 02904 Phone: 401-274-2500 | |
Mr. Brian P Shea, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 50 Park Row W, #426, Providence, RI 02903 Phone: 617-455-2788 | |
Alisha Choquette, AA, ACDP Counselor Medicare: Not Enrolled in Medicare Practice Location: 66 Burnett St, Providence, RI 02907 Phone: 401-785-0050 Fax: 401-941-0089 | |
Betsy Riccio, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 River Ave, Providence, RI 02908 Phone: 401-465-1955 | |
Miss Ashley L Addison, BA, LCDP, CCSP Counselor Medicare: Not Enrolled in Medicare Practice Location: 530 N Main St, Providence, RI 02904 Phone: 401-276-4100 | |
Jennifer Ortiz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 66 Pavilion Ave, Providence, RI 02905 Phone: 401-461-9110 | |
Shane Lima, Counselor Medicare: Not Enrolled in Medicare Practice Location: 66 Pavilion Ave, Providence, RI 02905 Phone: 401-461-9110 |