Pendergast, Michael Cole

Pendergast, Michael Cole is an individual health care provider with primary practice located at 4705A Old Post Rd , Charlestown RI 02813-1819. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Pendergast, Michael Cole can be contacted via phone (401) 364-7705.

Contact Information

Primary practice address
4705A Old Post Rd Charlestown RI 02813-1819
Phone: (401) 364-7705
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X ISW01338 Rhode Island

Profile Details

NPI number 1124181243
LBN Legal business name Pendergast, Michael Cole
Credentials MSW, LICSW, ACSW
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated Aug 4th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124181243 NPPES
Rhode Island MEDICAID MP34524
Rhode Island Other 27303-7
Rhode Island Other 408142

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