Ms. Tinatin Surguladze, DHD
Psychologist in Providence, Rhode Island
1700289360- Practice location
- 205 Waterman St Suite 106, Providence, RI 02906
- Phone
- 857-333-0533
- Fax
- —
- Last updated
- April 29, 2020
Tinatin Surguladze is a Psychologist based in Providence, RI. Tinatin Surguladze practices in Providence, RI and has the professional credentials of DHD. The NPI Number for Tinatin Surguladze is 1700289360 and holds a License No. 11259 (MA). The current practice location address for Tinatin Surguladze is 205 Waterman St Suite 106, Providence, RI 02906 and can be reached out via phone at 857-333-0533.
Provider Profile Details
- NPI Number
- 1700289360
- Provider Name
- Tinatin Surguladze
- Credential
- DHD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 205 Waterman St Suite 106, Providence, RI 02906
- Phone Number
- 857-333-0533
- Primary Taxonomy
- Psychologist · 103T00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- September 26, 2014
- Last Update Date
- April 29, 2020
- Certification Date
- April 29, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 205 Waterman St Suite 106
Providence, RI 02906 - City
- Providence
- State
- Rhode Island
- Zip
- 02906
- Phone Number
- 857-333-0533
Provider Business Mailing Address Details
- Address
- 3 Burgess RD
Foster, RI 02825 - City
- Foster
- State
- RI
- Zip
- 02825
- Phone Number
- 857-333-0533
License Information
- Taxonomy (1)
- Counselor · 101Y00000X
- License Number (2)
- 11259
- License State (2)
- MA
- Taxonomy (2)
- Psychologist · 103T00000X
- License Number (3)
- PS01795
- License State (3)
- RI
- Taxonomy (3)
- Psychologist · 103T00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Ms. Tinatin Surguladze, DHD?
The NPI number of Ms. Tinatin Surguladze, DHD is 1700289360. It was assigned on September 26, 2014 and is currently active in the NPPES registry.
What is the specialty of Ms. Tinatin Surguladze, DHD?
Ms. Tinatin Surguladze, DHD is registered under the primary taxonomy Psychologist (code 103T00000X), licensed in MA under license number 11259.
Where does Ms. Tinatin Surguladze, DHD practice?
The practice location is 205 Waterman St Suite 106, Providence, RI 02906. The office can be reached at 857-333-0533 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1700289360 directly on the NPPES registry website.