Organization
AUTHENTIC CHANGE PSYCHOTHERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE HUMINSKI LICSW (OWNER)
(401) 489-6885
Entity
Organization
Contact information
Practice address
154 WATERMAN ST., SUITE 15, 3RD FLOOR, PROVIDENCE, RI 02906
(401) 489-6885
Mailing address
133 GLENWOOD AVE, PAWTUCKET, RI 02860-5905
(401) 489-6885
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/10/2022
Last updated
01/23/2022
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