Provider Demographics
NPI:1053404004
Name:DEQUATTRO, RANA M (LCMHC)
Entity type:Individual
Prefix:MRS
First Name:RANA
Middle Name:M
Last Name:DEQUATTRO
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MULBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-2503
Mailing Address - Country:US
Mailing Address - Phone:401-465-5144
Mailing Address - Fax:
Practice Address - Street 1:50 MULBERRY CIR
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-2503
Practice Address - Country:US
Practice Address - Phone:401-465-5144
Practice Address - Fax:401-349-0494
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI30267-4OtherBLUECROSS
RI408908OtherBLUECHIP
RI1038440OtherBEACON HEALTH STRATEGIES
RI62-27038OtherUNITED HEALTH