Beauregard, Brenda
Beauregard, Brenda is an individual health care provider with primary practice located at 249 Roosevelt Ave , Pawtucket RI 02860-2134. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Beauregard, Brenda can be contacted via phone (401) 724-8400.Contact Information
Primary practice address
249 Roosevelt Ave
Pawtucket RI 02860-2134
Phone: (401) 724-8400
Fax: (401) 365-1100
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | LCDP345 | Rhode Island |
Profile Details
| NPI number | 1659409647 |
|---|---|
| LBN Legal business name | Beauregard, Brenda |
| Credentials | LCDP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 1st, 2007 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659409647 | NPPES |
| Rhode Island | MEDICAID | GH56996 |
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