CODAC BEHAVIORAL HEALTHCARE (NPI# 1780082743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780082743 |
| Entity Type | Organization |
| Organization Name | CODAC BEHAVIORAL HEALTHCARE |
| Practice Address |
1052 Park Ave Cranston RI 02910-3225 |
| Practice Telephone | 4012755039 |
| Practice Fax Number | 4019423590 |
| Mailing Telephone | 4012755039 |
| Mailing Fax Number | 4019423590 |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |
| Authorized Official Name | MS. ALISHA BOURDEAU (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 4012755039 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | CDP00575 | RI | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CODAC BEHAVIORAL HEALTHCARE | 1052 Park Ave, Cranston, RI 02910-3225 |
| Street Address |
1052 PARK AVE |
| City | CRANSTON |
| State | RI |
| Zip Code | 02910-3225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295731321 | Codac Inc | Clinic/Center | 1052 Park Ave, Codac Cranston, Cranston, RI 02910 | 2005-06-23 |
| 1467988683 | Codac Inc | Peer Specialist | 1052 Park Ave, Cranston, RI 02910-3225 | 2017-05-08 |
| 1497144752 | Ileana Santiago | Counselor | 1052 Park Ave, Cranston, RI 02910-3225 | 2015-01-09 |
| 1427454453 | Jessica Elliott | Counselor | 1052 Park Ave, Cranston, RI 02910-3225 | 2014-11-19 |
| 1316196900 | Margarida A Renzi | Counselor | 1052 Park Ave, Cranston, RI 02910-3225 | 2008-09-18 |
| 1629249156 | Tammy Brown | Counselor | 1052 Park Ave, Cranston, RI 02910-3225 | 2008-03-12 |
| 1851513394 | Codac Inc | Peer Specialist | 1052 Park Ave, Cranston, RI 02910-3225 | 2007-05-03 |
| 1710109848 | Jane F Dilorenzo | Counselor | 1052 Park Ave, Cranston, RI 02910-3225 | 2007-05-02 |
| 1023043056 | Susan H Hart | Internal Medicine | 1052 Park Ave, Cranston, RI 02910-3225 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417443441 | Luis Guzman | Durable Medical Equipment & Medical Supplies | 29 Rolfe Square, Cranston, MA 02910 | 2018-07-02 |
| 1023535010 | Sarah Pagliarini | Nurse Practitioner | 725 Reservoir Ave Ste 308, Cranston, RI 02910 | 2017-08-29 |
| 1861890105 | Marissa Falco | Counselor | 1471 Elmwood Avenue, Cranston, RI 02910 | 2014-12-19 |
| 1952702425 | Lauren Beth Shibley | Counselor | 825 Pontiac Avenue Apt 14101, Cranston, RI 02910 | 2014-09-15 |
| 1831516632 | Kelly Kilmartin | Counselor | 471 Elmwood Avenue, Cranston, RI 02910 | 2014-03-19 |
| 1376784827 | Michael Eric Schaffer | Counselor | 989 Reservoir Ave Ste 104, Cranston, RI 02910 | 2009-03-13 |
| 1639384829 | Dolores Maiello Ciambrone | Social Worker | 145 Harmon Ave, Cranston, RI 02910 | 2007-05-11 |
| 1750502241 | Mary Jane Boucher | Counselor | Codac Cranston, 1052 Park Ave, Cranston, RI 02910 | 2007-05-01 |
| 1134250715 | Michele Bailey Chaudhry | Social Worker | 935 Reservoir Ave, Cranston, RI 02910 | 2007-03-08 |
| 1487703658 | Karen M Mega | Dentist | 567 Reservoir Ave, Cranston, RI 02910 | 2007-01-09 |
| Find all providers in zip 02910 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134759871 | Create Balance, LLC | Community/Behavioral Health | 155 Park Ave Ste 21, Cranston, RI 02905-2627 | 2020-01-22 |
| 1053820274 | Inner Peace Counseling, LLC | Community/Behavioral Health | 875 Oaklawn Ave Ste 303, Cranston, RI 02920-2826 | 2017-09-20 |
| 1528347093 | Discovery House | Community/Behavioral Health | 48 Dartmouth Rd, Cranston, RI 02920-6135 | 2011-08-15 |
| 1649714023 | Seven Hills Rhode Island | Community/Behavioral Health | 178 Norwood Ave, Cranston, RI 02905-3923 | 2016-12-05 |
| 1770849259 | Comprehensive Community Action, Inc | Community/Behavioral Health | 311 Doric Ave, Cranston, RI 02910-2903 | 2012-04-09 |
| 1770617516 | Rhode Island Counseling and Hypnotherapy Center Inc | Community/Behavioral Health | 875 Oaklawn Ave, Cranston, RI 02920-2826 | 2007-03-15 |
| 1649305830 | St. Mary's Home for Children | Community/Behavioral Health | 135 Norwood Ave, Cranston, RI 02905-3914 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902406986 | Linds 5, Inc. | Community/Behavioral Health | 152 Harris Rd, Smithfield, RI 02917-1931 | 2020-10-28 |
| 1962002006 | East Side Psychotherapy, Inc. | Community/Behavioral Health | 205 Waterman St # 201, Providence, RI 02906-4313 | 2020-10-28 |
| 1508488305 | Island Light Psychotherapy, LLC | Community/Behavioral Health | 11 King Charles Dr Ste A, Portsmouth, RI 02871-1364 | 2020-05-14 |
| 1003323221 | Kathlyn Heckart LLC | Community/Behavioral Health | 38 Bellevue Ave Ste J, Newport, RI 02840-3260 | 2018-01-09 |
| 1912412800 | Paths of Rhode Island, LLC | Community/Behavioral Health | 30 W Main St Unit B, North Kingstown, RI 02852-5112 | 2017-12-13 |
| 1336677541 | Theadore Perry | Community/Behavioral Health | 251 Indiana Ave, Providence, RI 02905-2822 | 2017-06-01 |
| 1720512536 | Stimz, Inc. | Community/Behavioral Health | 73 Red Brook Ln, West Warwick, RI 02893-7427 | 2017-04-18 |
| 1255863387 | Ludmyr Merlain | Community/Behavioral Health | 52 Felix St, Providence, RI 02908-4837 | 2017-03-29 |
| 1164970331 | Till Inc | Community/Behavioral Health | 110 Parkview Dr Apt 21, Pawtucket, RI 02861-3967 | 2016-09-16 |
| 1841659802 | Hope Counseling Services | Community/Behavioral Health | 29 Smith Ave, #2, Greenville, RI 02828-1730 | 2016-02-19 |
| Find all providers with the same taxonomy | ||||
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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.