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HOME PORT THERAPY
NPI 1740460872
Clinic/Center - Adult Mental Health in Peace Dale, RI

Active since November 06, 2007
23 NORTH RD STE A25, PEACE DALE, RI 02879(401) 932-1181(401) 783-1154 Get Directions Write a Review

NPPES record last updated: November 6, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Other Providers Same Location
  5. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Adult Mental Health

About HOME PORT THERAPY

This page provides the complete NPI Profile along with additional information for Home Port Therapy, a provider established in Peace Dale, Rhode Island operating as a Clinic/center, focusing in adult mental health . The healthcare provider is registered in the NPI registry with number 1740460872 assigned on November 2007. The practitioner's primary taxonomy code is 261QM0850X with license number MFT00100 (RI). The provider is registered as an organization and their NPI record was last updated 19 years ago. The authorized official of this NPI record is Mr. Reynard Bullock Ms Lmft (Owner)

NPI
1740460872 Verify this NPI
Provider Name
HOME PORT THERAPY
Entity Type
Organization
Location Address
23 NORTH RD STE A25 PEACE DALE, RI 02879
Location Phone
(401) 932-1181
Location Fax
(401) 783-1154
Mailing Address
23 NORTH RD STE A25 PEACE DALE, RI 02879
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-06-2007
Last Update Date
11-06-2007
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Adult Mental Health

Taxonomy Code
261QM0850X
Type
Ambulatory Health Care Facilities
License No.
MFT00100
License State
RI
Taxonomy Description
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. REYNARD BULLOCK MS LMFT

Authorized Official Title
OWNER
Authorized Official Phone
(401) 932-1181

Reviews for HOME PORT THERAPY

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

AMANDA L FONTAINE LMFT
Marriage & Family Therapist
23 NORTH RD STE A25
PEACE DALE, RI 02879
Washington County (401) 487-7042

Frequently Asked Questions

What is HOME PORT THERAPY's NPI number?

The NPI number assigned to this healthcare provider is 1740460872, enumerated as an "organization" on November 06, 2007.

Where is the provider located?

The provider is located at 23 NORTH RD STE A25 PEACE DALE, RI 02879 and the phone number is (401) 932-1181.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QM0850X and a focus in Adult Mental Health.