Organization
COMMUNITY AND SCHOOL SUPPORT SERVICES
Active
Organization
COMMUNITY AND SCHOOL SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DUMAS PHD (PRESIDENT)
(401) 447-4616
Entity
Organization
Contact information
Practice address
62 GESLER ST, PROVIDENCE, RI 02909-1506
(401) 831-2794
(401) 490-0548
Mailing address
62 GESLER ST, PROVIDENCE, RI 02909-1506
(401) 831-2794
(401) 490-0548
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BE14779
—
RI
Enumeration date
10/04/2017
Last updated
10/04/2017
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