Provider Demographics
NPI:1972349694
Name:CLINIC OF RESILIENCE AND EMPOWERMENT (CORE) LLC
Entity type:Organization
Organization Name:CLINIC OF RESILIENCE AND EMPOWERMENT (CORE) LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PRACHI
Authorized Official - Middle Name:
Authorized Official - Last Name:KENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-249-0675
Mailing Address - Street 1:5600 POST ROAD # 114
Mailing Address - Street 2:PMB 301
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818
Mailing Address - Country:US
Mailing Address - Phone:401-249-0675
Mailing Address - Fax:
Practice Address - Street 1:600 MOUNT PLEASANT AVE 222 HORACE MANN
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908
Practice Address - Country:US
Practice Address - Phone:401-249-0675
Practice Address - Fax:401-496-1486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty