# ANGELA RUDNER PSYCHOTHERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114378098
- **Authorized official:** MRS. ANGELA SUSAN RUDNER LICSW (PRESIDENT)
- **Authorized official phone:** (401) 573-9905

## Contact information

- **Practice address:** 1 RICHMOND SQ, STE152 E, PROVIDENCE, RI 02906-5139
- **Practice address phone:** (401) 573-9905
- **Mailing address:** 2 REGENCY PLZ APT 1212, PROVIDENCE, RI 02903-3156
- **Mailing address phone:** (410) 370-0076

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 116924 | MA | — |
| 1041C0700X | Clinical Social Worker | 15954 | MD | — |
| 1041C0700X | Clinical Social Worker | ISW02235 | RI | Yes |

## Other

- **Enumeration date:** 06/22/2016
- **Last updated:** 06/22/2016