Organization
DIVERSITY COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE MATEO GOMEZ (CREDENTIALING CONSULTANT)
(248) 470-8918
Entity
Organization
Contact information
Practice address
1020 PARK AVE, CRANSTON, RI 02910-3227
(401) 396-7649
Mailing address
1020 PARK AVE, CRANSTON, RI 02910-3227
(248) 470-8918
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
03/20/2022
Last updated
06/10/2025
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