Individual
ERICK JONATHAN FEDORENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6689
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS02387
RI
Other
Enumeration date
07/16/2025
Last updated
08/25/2025
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