# EMDR & SOMATIC PSYCHOTHERAPIES OF RHODE ISLAND

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South County Mental Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912598046
- **Authorized official:** MS. MADRONE PHOENIX LICSW (OWNER)
- **Authorized official phone:** (401) 297-0692

## Contact information

- **Practice address:** 1 RICHMOND SQ STE 333C, PROVIDENCE, RI 02906-5139
- **Practice address phone:** (401) 441-5834
- **Practice address fax:** (401) 210-8248
- **Mailing address:** PO BOX 5, KINGSTON, RI 02881-0005
- **Mailing address phone:** (401) 441-5834
- **Mailing address fax:** (401) 210-8248

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/01/2021
- **Last updated:** 10/13/2022