Provider Demographics
NPI:1861909574
Name:ALMEIDA-RUSSELL, TONI L (LCDP, LADC-I)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:L
Last Name:ALMEIDA-RUSSELL
Suffix:
Gender:F
Credentials:LCDP, LADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 PEQUOT AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-9739
Mailing Address - Country:US
Mailing Address - Phone:401-935-5424
Mailing Address - Fax:
Practice Address - Street 1:451 PEQUOT AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-9739
Practice Address - Country:US
Practice Address - Phone:401-935-5424
Practice Address - Fax:401-935-5424
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23206101YA0400X
RICDP00720101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI82-3723101OtherTIN