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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