Organization
COUNSELING AND NEUROFEEDBACK CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELAINE LOUISE MARTIN LICSW, ACSW, LCDP II (PRESIDENT)
(401) 709-9497
Entity
Organization
Contact information
Practice address
120 WAYLAND AVE, SUITE 1, PROVIDENCE, RI 02906-4318
(401) 709-9497
(401) 709-3776
Mailing address
120 WAYLAND AVE, SUITE 1, PROVIDENCE, RI 02906-4318
(401) 709-9497
(401) 709-3776
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00638
RI
Other
Enumeration date
08/28/2008
Last updated
08/28/2008
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