Provider Demographics
NPI:1871321646
Name:DOBSON, KAITLIN JEAN (LHMCA)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:JEAN
Last Name:DOBSON
Suffix:
Gender:F
Credentials:LHMCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RICHMOND SQ STE 350W
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5165
Mailing Address - Country:US
Mailing Address - Phone:401-227-0372
Mailing Address - Fax:877-455-9466
Practice Address - Street 1:1 RICHMOND SQ STE 350W
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5165
Practice Address - Country:US
Practice Address - Phone:401-227-0372
Practice Address - Fax:877-455-9466
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00219-A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health