| Bewell Therapy Collaborative, Llc | |
|
1060 Tiogue Ave Unit 2 Coventry RI 02816-6114 | |
| (401) 250-4174 | |
| Not Available |
| Full Name | Bewell Therapy Collaborative, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1060 Tiogue Ave Unit 2, Coventry, Rhode Island |
| Authorized Official Name and Position | Richelle Dowell (OWNER) |
| Authorized Official Contact | 4012504174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bewell Therapy Collaborative, Llc 1060 Tiogue Ave Unit 2 Coventry RI 02816-6114 Ph: (401) 250-4174 | Bewell Therapy Collaborative, Llc 1060 Tiogue Ave Unit 2 Coventry RI 02816-6114 Ph: (401) 250-4174 |
| NPI Number | 1629769591 |
|---|---|
| Provider Enumeration Date | 05/19/2023 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Medicare PECOS PAC ID | 9537699798 |
|---|---|
| Medicare Enrollment ID | O20250204001587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629769591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Samantha Sandland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780103101 PECOS PAC ID: 6204168446 Enrollment ID: I20191021003271 |
| Provider Name | Richelle Dowell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326523655 PECOS PAC ID: 7719395185 Enrollment ID: I20210423001123 |
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