Provider Demographics
NPI:1730238056
Name:PARENTEAU, MICHAEL (LMHC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:PARENTEAU
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-5815
Mailing Address - Country:US
Mailing Address - Phone:401-738-6584
Mailing Address - Fax:
Practice Address - Street 1:2893 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3117
Practice Address - Country:US
Practice Address - Phone:401-738-6584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00165101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
410471OtherBLUE CHIP
62-41094OtherUBH
RIMP05339Medicaid
26527-4OtherBLUE CROSS BLUE SHIELD