Organization
THE MIRIAM HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER M MARKELL (EVP & CFO)
(401) 444-7914
Entity
Organization
Contact information
Practice address
146 W RIVER ST STE 11A, PROVIDENCE, RI 02904-2609
(401) 793-8770
(401) 793-8709
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
207R00000X
Internal Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225073638
—
RI
05
—
MI72815 - PSYCH
—
RI
Enumeration date
06/19/2006
Last updated
02/26/2026
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