Eden, Kathryn B
Eden, Kathryn B is an sole proprietor health care provider with primary practice located at 610 Wampanoag Trail East Bay Mental Health Center, East Providence RI 02915. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Eden, Kathryn B can be contacted via phone (401) 431-9870.Contact Information
Primary practice address
610 Wampanoag Trail East Bay Mental Health Center
East Providence RI 02915
Phone: (401) 431-9870
Fax: (401) 435-7486
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 15W01525 | Rhode Island |
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1021862 | Massachusetts |
Profile Details
NPI number | 1649243981 |
---|---|
LBN Legal business name | Eden, Kathryn B |
Credentials | MSW LICSW |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 8th, 2006 |
Last updated | Oct 7th, 2008 - about 16 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 | 1649243981 | NPPES |
Rhode Island | MEDICAID | KE54562 | |
Rhode Island | Other | 413914 | |
Rhode Island | Other | 32118-9 | |
Rhode Island | Other | 62-75119 |
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