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Organization
COSTA THERAPY SERVICES
Active
Organization
COSTA THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTINA M COSTA LICSW (SOCIAL WORKER)
(401) 400-2023
Entity
Organization
Contact information
Practice address
1240 PAWTUCKET AVE STE 3, RUMFORD, RI 02916-1431
(401) 400-2023
Mailing address
PO BOX 41335, PROVIDENCE, RI 02940-1335
(401) 400-2023
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
1041S0200X
School Social Worker
—
NULL
1041S0200X
School Social Worker
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
Other
Enumeration date
01/04/2021
Last updated
01/11/2021
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