Organization
BROADWAY PSYCHOTHERAPY, INC.
Active
Organization
BROADWAY PSYCHOTHERAPY, INC.
Active
Other names
Health Behavior Consultants, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY P. MIGNEAULT PH.D. (PRESIDENT)
(401) 270-9808
Entity
Organization
Contact information
Practice address
347 BROADWAY, PROVIDENCE, RI 02909-1101
(401) 270-9808
(401) 354-7455
Mailing address
347 BROADWAY, PROVIDENCE, RI 02909-1101
(401) 270-9808
(401) 354-7455
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS00585
RI
1041C0700X
Clinical Social Worker
ISW00174
RI
Other
Enumeration date
04/25/2008
Last updated
05/03/2017
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