| Diversity Counseling Llc | |
|
111 Wayland Ave Providence RI 02906-4371 | |
| (401) 396-7649 | |
| Not Available |
| Full Name | Diversity Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 111 Wayland Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Jose Gabriel Cruz Rodriguez (OWNER) |
| Authorized Official Contact | 4013967649 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diversity Counseling Llc 111 Wayland Ave Providence RI 02906-4371 Ph: (401) 396-7649 | Diversity Counseling Llc 111 Wayland Ave Providence RI 02906-4371 Ph: (401) 396-7649 |
| NPI Number | 1033868930 |
|---|---|
| Provider Enumeration Date | 03/20/2022 |
| Last Update Date | 12/15/2023 |
| Certification Date | 12/15/2023 |
| Medicare PECOS PAC ID | 7719330034 |
|---|---|
| Medicare Enrollment ID | O20240201004140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033868930 | NPI | - | NPPES |
| Provider Name | Carmen Benjamin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063905180 PECOS PAC ID: 1759756406 Enrollment ID: I20230530001025 |
| Provider Name | Fraynelis Y. Andujar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750072740 PECOS PAC ID: 5092172775 Enrollment ID: I20230612002280 |
| Provider Name | Jose G. Cruz Rodriguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649884248 PECOS PAC ID: 5991158214 Enrollment ID: I20240201004266 |
| Provider Name | Teresa M Dombrowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528701638 PECOS PAC ID: 9032552674 Enrollment ID: I20240209003550 |
| Provider Name | Claritza Tejeda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164072443 PECOS PAC ID: 6103298831 Enrollment ID: I20240311003539 |
| Provider Name | Melissa Mckenna |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114671609 PECOS PAC ID: 4284070327 Enrollment ID: I20240311003601 |
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