BRENDA BEAUREGARD (NPI# 1659409647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659409647 |
| Entity Type | Individual |
| Full Name | BRENDA BEAUREGARD |
| Credential | LCDP |
| Practice Address |
249 Roosevelt Ave Pawtucket RI 02860-2134 |
| Practice Telephone | 4017248400 |
| Practice Fax Number | 4013651100 |
| Mailing Telephone | 4017248400 |
| Mailing Fax Number | 4013651100 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LCDP345 | RI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | GH56996 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912466822 | Brenda Beauregard | Social Worker | 25 W Main St, Conway, NH 03818-6142 | 2019-03-19 |
| Street Address |
249 ROOSEVELT AVE |
| City | PAWTUCKET |
| State | RI |
| Zip Code | 02860-2134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324101 | Gateway Healthcare, Inc | Case Management | 249 Roosevelt Ave, Unit 205, Pawtucket, RI 02860-2134 | 2005-05-23 |
| 1487267449 | Silifat Adedayo Ainabe | Clinic/Center | 249 Roosevelt Ave, Pawtucket, RI 02860-2134 | 2020-08-28 |
| 1093379190 | Carla Justiniano | Social Worker | 249 Roosevelt Ave, Pawtucket, RI 02860-2134 | 2019-04-24 |
| 1467915561 | Haleigh O'brien | Social Worker | 249 Roosevelt Ave, Pawtucket, RI 02860-2134 | 2019-04-08 |
| 1235614769 | Alim Hos | Counselor | 249 Roosevelt Ave, Pawtucket, RI 02860-2134 | 2018-10-01 |
| 1982193884 | Angela Gallo | Social Worker | 249 Roosevelt Ave, Pawtucket, RI 02860-2134 | 2018-05-07 |
| 1033607072 | Jennifer M Pelkey | Counselor | 249 Roosevelt Ave, Pawtucket, RI 02860-2134 | 2018-04-25 |
| 1801323910 | Jenna Petrucci | Counselor | 249 Roosevelt Ave, Pawtucket, RI 02860-2134 | 2017-05-19 |
| 1942736855 | Briana Ransford | Counselor | 249 Roosevelt Ave, Suite 205, Pawtucket, RI 02860-2134 | 2017-05-11 |
| 1275071409 | Wanda M Angel | Social Worker | 249 Roosevelt Ave, Pawtucket, RI 02860-2134 | 2017-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972096923 | Lmb Medical LLC | Internal Medicine | 127 School St, Pawtucket, RI 02860 | 2018-06-13 |
| 1215420435 | Tyla Jackson | Behavior Technician | 70 Wood St Apt 22, Pawtucket, RI 02860 | 2018-06-12 |
| 1376048637 | Michael A Iadevaia | Family Medicine | 111 Brewster St Fl 3, Pawtucket, RI 02860 | 2018-03-28 |
| 1730690488 | Anthony Edwin Ramicone | Physician Assistant | 407 East Ave Ste 120, Pawtucket, RI 02860 | 2017-10-21 |
| 1669991352 | Kathleen K. Kroessler, Md; Neurology & Acupuncture, Inc. PC | Clinic/Center | 407 East Ave; Suite 110, Pawtucket, RI 02860 | 2017-09-13 |
| 1841716230 | Ri Alternative Academy Management, LLC | Local Education Agency (LEA) | 249 Roosevelt Avenue, Pawtucket, RI 02860 | 2017-08-17 |
| 1396265724 | Hannah R Stoops | Family Medicine | 111 Brewster St Fcc A, Pawtucket, RI 02860 | 2017-06-27 |
| 1427578400 | Shaun Michael Flynn | Family Medicine | 111 Brewster St, Fcc A, Pawtucket, RI 02860 | 2017-06-21 |
| 1073051843 | Laura Jane Amaral | Counselor | 750 East Ave Unit 1e, Pawtucket, RI 02860 | 2017-02-01 |
| 1063862027 | Stephanie Shoppell | Counselor | 105 Bacon Street, Pawtucket, RI 02860 | 2016-06-20 |
| Find all providers in zip 02860 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831741156 | Lauren D'andrea | Counselor | 50 Tobie Ave, Pawtucket, RI 02861-2912 | 2019-07-16 |
| 1073051843 | Laura Jane Amaral | Counselor | 750 East Ave Unit 1e, Pawtucket, RI 02860 | 2017-02-01 |
| 1760929012 | Taylor Alexis Daddario | Counselor | 57 Charlton Ave, Pawtucket, RI 02860-6233 | 2017-01-25 |
| 1164887444 | Lori-ann Tetreault | Counselor | 15 Woodhaven Rd, Pawtucket, RI 02861-3530 | 2015-12-30 |
| 1285018077 | David Lussier | Counselor | 80 Summit St, Pawtucket, RI 02860-4206 | 2015-07-13 |
| 1053533182 | Janet Hindley | Counselor | 115 Hanover Ave, Pawtucket, RI 02861-2129 | 2007-05-02 |
| 1447475074 | Robin N. Pierce-pacheco | Counselor | 31 North Union Street, Pawtucket, RI 02860 | 2007-04-17 |
| 1447375662 | Susan D. Wallace | Counselor | 166 Pawtucket Avenue, Pawtucket, RI 02860-3811 | 2007-03-20 |
| 1649300765 | Geovany Orrego | Counselor | 101 Bacon St # 103, Pawtucket, RI 02860-5542 | 2007-03-07 |
| 1194828749 | Meredith M Denno | Counselor | 166 Pawtucket Ave, Pawtucket, RI 02860 | 2006-09-07 |
| Find all providers in PAWTUCKET | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.