Provider Demographics
NPI:1053190561
Name:HARRINGTON, JOELLE MARIE (EDS)
Entity type:Individual
Prefix:
First Name:JOELLE
Middle Name:MARIE
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 ALLEN ST UNIT 209
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-4399
Mailing Address - Country:US
Mailing Address - Phone:401-298-0088
Mailing Address - Fax:
Practice Address - Street 1:2220 BRONCOS HWY
Practice Address - Street 2:
Practice Address - City:BURRILLVILLE
Practice Address - State:RI
Practice Address - Zip Code:02830-1628
Practice Address - Country:US
Practice Address - Phone:401-568-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA507223103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool