Provider Demographics
NPI:1396261392
Name:KEARNS, MARIE PAGE (MA, CGS, LMHC)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:PAGE
Last Name:KEARNS
Suffix:
Gender:F
Credentials:MA, CGS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 TIDEWATER DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-4622
Mailing Address - Country:US
Mailing Address - Phone:401-487-8143
Mailing Address - Fax:
Practice Address - Street 1:1035 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3363
Practice Address - Country:US
Practice Address - Phone:401-785-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00890101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health