Provider Demographics
NPI:1255802096
Name:OCEAN STATE THERAPY AND WELLNESS. LLC
Entity type:Organization
Organization Name:OCEAN STATE THERAPY AND WELLNESS. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FINCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-374-2955
Mailing Address - Street 1:235 OLD FLAT RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-5149
Mailing Address - Country:US
Mailing Address - Phone:401-374-2955
Mailing Address - Fax:401-268-3887
Practice Address - Street 1:130 TOWER HILL RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4804
Practice Address - Country:US
Practice Address - Phone:401-268-3886
Practice Address - Fax:401-268-3887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW017771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty