# COUNSELING AND NEUROFEEDBACK CENTER, INC.

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

## Provider details

- **NPI number:** 1578711990
- **Authorized official:** MS. ELAINE LOUISE MARTIN LICSW, ACSW, LCDP II (PRESIDENT)
- **Authorized official phone:** (401) 709-9497

## Contact information

- **Practice address:** 120 WAYLAND AVE, SUITE 1, PROVIDENCE, RI 02906-4318
- **Practice address phone:** (401) 709-9497
- **Practice address fax:** (401) 709-3776
- **Mailing address:** 120 WAYLAND AVE, SUITE 1, PROVIDENCE, RI 02906-4318
- **Mailing address phone:** (401) 709-9497
- **Mailing address fax:** (401) 709-3776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | ISW00638 | RI | Yes |

## Other

- **Enumeration date:** 08/28/2008
- **Last updated:** 08/28/2008