Provider Demographics
NPI:1558755082
Name:CHETEYAN, SOUAD (APRN, BSN, MED, MSN)
Entity type:Individual
Prefix:MRS
First Name:SOUAD
Middle Name:
Last Name:CHETEYAN
Suffix:
Gender:F
Credentials:APRN, BSN, MED, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-3836
Mailing Address - Country:US
Mailing Address - Phone:401-280-1014
Mailing Address - Fax:
Practice Address - Street 1:315 MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-3836
Practice Address - Country:US
Practice Address - Phone:401-751-4833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI04779363LF0000X
RI51102101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty