Provider Demographics
NPI:1487236097
Name:PARENT, JUSTIN (PHD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:PARENT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SCRABBLETOWN RD STE A
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-3638
Mailing Address - Country:US
Mailing Address - Phone:401-268-5333
Mailing Address - Fax:855-268-5333
Practice Address - Street 1:420 SCRABBLETOWN RD STE A
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-3638
Practice Address - Country:US
Practice Address - Phone:401-268-5333
Practice Address - Fax:855-268-5333
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10666103TC2200X
RIPS01955103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent