Individual
ROBERT JAMES BROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDP
Contact information
Practice address
2198 WALLUM LAKE RD, PASCOAG, RI 02859
(401) 568-6670
Mailing address
528 N MAIN ST, PROVIDENCE, RI 02904-5757
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDP00115
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104847946
THE PROVIDENCE CENTER NPI
RI
01
—
1427087782
UBH
RI
01
—
23770
BLUE CROSS
RI
01
—
410282
BLUE CHIP
RI
05
—
RB59560
—
RI
Enumeration date
06/30/2006
Last updated
03/27/2009
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