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Individual

KIPP R LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMHC

Contact information

Practice address
68 CUMBERLAND ST, SUITE 102, WOONSOCKET, RI 02895-3300
(401) 356-1940
Mailing address
68 CUMBERLAND STREET SUITE 102, WOONSOCKET, RI 02895
(401) 356-1940

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
167
RI
101YM0800X
Mental Health Counselor
Primary
MHC00446
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
167
COUNSELOR
RI
05
KL69638
RI
Enumeration date
02/15/2008
Last updated
04/25/2013
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