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Organization
THE PROVIDENCE CENTER INC
Active
Organization
THE PROVIDENCE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN L RODGERS (MANAGER PAYER ENROLLMENT)
(401) 273-0641
Entity
Organization
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 528-0110
(401) 528-0188
Mailing address
171 SERVICE AVE, BLDG 2 FLOOR 2, WARWICK, RI 02886-1015
(401) 273-0641
(401) 273-2919
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
163W00000X
Registered Nurse
—
—
175T00000X
Peer Specialist
—
—
207SG0205X
Ph.D. Medical Genetics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
631
RI
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410282
BLUE CHIP
RI
01
—
50-64724
UNITED BEHAVIORAL HEALTH
RI
05
—
PC02213
—
RI
05
—
PC02214
—
RI
01
—
PC07340
DCYF-MEDICAID
RI
05
—
PC11826
—
RI
Enumeration date
07/21/2006
Last updated
08/21/2026
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