Provider Demographics
NPI:1841180023
Name:PUNIELLO, KERRY (LMHCA)
Entity type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:
Last Name:PUNIELLO
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MASSASOIT AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-2017
Mailing Address - Country:US
Mailing Address - Phone:401-321-2136
Mailing Address - Fax:
Practice Address - Street 1:400 MASSASOIT AVE STE 111
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-2017
Practice Address - Country:US
Practice Address - Phone:401-321-2136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00395-A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health