Provider Demographics
NPI:1316196900
Name:RENZI, MARGARIDA A (MA,RYT,LCDP)
Entity type:Individual
Prefix:
First Name:MARGARIDA
Middle Name:A
Last Name:RENZI
Suffix:
Gender:F
Credentials:MA,RYT,LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S COUNTY TRL
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5219
Mailing Address - Country:US
Mailing Address - Phone:401-294-2183
Mailing Address - Fax:
Practice Address - Street 1:1052 PARK AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-3225
Practice Address - Country:US
Practice Address - Phone:401-461-5056
Practice Address - Fax:401-943-2167
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILCDP00432101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILCDP00432OtherLCDP