Organization
INGA KORSGAARD LLC
Active
Parent organization
INGA KORSGAARD LLC
Other names
Mellem Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
INGA KORSGAARD LLC
Authorized official
DR. INGA KORSGAARD PHD (OWNER, CLINICAL DIRECTOR)
(347) 674-1136
Entity
Organization
Contact information
Practice address
145 WATERMAN ST, PROVIDENCE, RI 02906-2128
(347) 674-1136
Mailing address
30 JOHN ST, PROVIDENCE, RI 02906-1043
(347) 549-0280
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/21/2023
Last updated
03/25/2024
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