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Organization
MICHAEL PENDERGAST
Active
Organization
MICHAEL PENDERGAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL COLE PENDERGAST LICSW (LICENSED INDEPENDENT SOCIAL WORKER)
(401) 301-4526
Entity
Organization
Contact information
Practice address
1130 TEN ROD RD, BUILDING D, SUITE 307-C, NORTH KINGSTOWN, RI 02852-4161
(401) 301-4526
Mailing address
1130 TEN ROD RD, BUILDING D, SUITE 307-C, NORTH KINGSTOWN, RI 02852-4161
(401) 301-4526
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01338
RI
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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