Individual
MS. KATHLEEN CARNEY LARISA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC, LADCI
Contact information
Practice address
610 WAMPANOAG TRAIL, EAST PROVIDENCE, RI 02916
(401) 431-9870
Mailing address
44 DON AVE, RUMFORD, RI 02916-2305
(617) 775-5400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00322
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32336-1
BLUE CROSS
RI
01
—
413987
BLUE CHIP
RI
05
—
KC65655
—
RI
Enumeration date
01/16/2007
Last updated
03/05/2008
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