Organization
PSYCHOLOGICAL CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL BLOCK PH.D (CO-DIRECTOR)
(401) 490-8900
Entity
Organization
Contact information
Practice address
49 PAVILION AVE, SUITE 105, PROVIDENCE, RI 02905-1534
(401) 490-8900
Mailing address
49 PAVILION AVE, SUITE 105, PROVIDENCE, RI 02905-1534
(401) 490-8900
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/11/2006
Last updated
06/15/2012
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