Provider Demographics
NPI:1366128209
Name:COMPANATICO, GENNA
Entity type:Individual
Prefix:
First Name:GENNA
Middle Name:
Last Name:COMPANATICO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 CENTERVILLE ROAD SUITE 105
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886
Mailing Address - Country:US
Mailing Address - Phone:401-773-3700
Mailing Address - Fax:401-773-3701
Practice Address - Street 1:469 CENTERVILLE ROAD SUITE 105
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886
Practice Address - Country:US
Practice Address - Phone:401-773-3700
Practice Address - Fax:401-773-3701
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health