Provider Demographics
NPI:1336591494
Name:OM THERAPY
Entity type:Organization
Organization Name:OM THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DASILVA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-497-8873
Mailing Address - Street 1:1 RICHMOND SQ STE 350W
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5165
Mailing Address - Country:US
Mailing Address - Phone:401-227-0372
Mailing Address - Fax:877-455-3466
Practice Address - Street 1:1 RICHMOND SQ STE 350W
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5165
Practice Address - Country:US
Practice Address - Phone:401-227-0372
Practice Address - Fax:877-455-9466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW020641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty