Provider Demographics
NPI:1194750851
Name:FAIOES, IRENE LOURDES (LMHC)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:LOURDES
Last Name:FAIOES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:IRENE
Other - Middle Name:LOURDES
Other - Last Name:CHMIELINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:191 SOCIAL STREET
Mailing Address - Street 2:SUITE 430
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3218
Mailing Address - Country:US
Mailing Address - Phone:401-766-1313
Mailing Address - Fax:401-766-3004
Practice Address - Street 1:191 SOCIAL STREET
Practice Address - Street 2:SUITE 430
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3218
Practice Address - Country:US
Practice Address - Phone:401-766-1313
Practice Address - Fax:401-766-3004
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIC127101Y00000X
RIMHC00435101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIIC58334Medicaid