Organization
PSYCHOLOGICAL ASSOCIATES OF WARWICK II, LLC
Active
Organization
PSYCHOLOGICAL ASSOCIATES OF WARWICK II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADEN JOEPHSON PH.D. (OWNER/PSYCHOLOGIST)
(917) 776-5433
Entity
Organization
Contact information
Practice address
889 CENTERVILLE RD, WARWICK, RI 02886-4342
(401) 826-8875
(401) 823-9180
Mailing address
889 CENTERVILLE RD, WARWICK, RI 02886-4342
(401) 826-8875
(401) 823-9180
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS01524
RI
1041C0700X
Clinical Social Worker
ISW01666
RI
106E00000X
Assistant Behavior Analyst
LBA00074
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000003916
BLUE CROSS AND BLUE SHIELD OF RI
RI
01
—
1101520
NEIGHBORHOOD HEALTH BEACON HEALTH OPTIONS
RI
Enumeration date
10/17/2016
Last updated
10/17/2016
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