Michael Pendergast

NPI #1043660202 in North Kingstown, Rhode Island

Provider Information

NPI Number: 1043660202
Entity Type: Organization
Organization Name: Michael Pendergast
Primary Specialty: Social Worker - Clinical
Enumeration Date: Jun 20, 2016
Last Updated: Jun 20, 2016

Practice Location

Address: 1130 TEN ROD RD
Address 2: BUILDING D, SUITE 307-C
City: North Kingstown
State: Rhode Island
ZIP Code: 02852-4161
Phone: (401) 301-4526

Authorized Official

Name: MR. MICHAEL COLE PENDERGAST, LICSW
Title: LICENSED INDEPENDENT SOCIAL WORKER
Phone: (401) 301-4526

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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