# KELLEY GEMMA, LLC DBA OCEAN STATE PSYCHOTHERAPY, INC.

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

## Provider details

- **NPI number:** 1821384207
- **Authorized official:** KELLEY E GEMMA LICSW (PRESIDENT/CLINICAL DIRECTOR)
- **Authorized official phone:** (401) 268-3886

## Contact information

- **Practice address:** 1130 TEN ROD RD, SUITE F 203, NORTH KINGSTOWN, RI 02852-4161
- **Practice address phone:** (401) 268-3886
- **Practice address fax:** (401) 268-3887
- **Mailing address:** 1130 TEN ROD RD, SUITE F 203, NORTH KINGSTOWN, RI 02852-4161
- **Mailing address phone:** (401) 268-3886
- **Mailing address fax:** (401) 268-3887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | ISW001777 | RI | Yes |

## Other

- **Enumeration date:** 06/23/2011
- **Last updated:** 06/23/2011