Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Roosevelt Dale

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1962375477

Roosevelt Dale is an Addiction (Substance Use Disorder) Counselor in Johnston, Rhode Island. Practices as a sole proprietor. Licensed in Rhode Island.

Licensed in
RI
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

806 Greenville Ave
Johnston, RI 02919-1305
Phone: (401) 516-1314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CDP01081 (RI)
Community Health Worker Taxonomy 172V00000X · Licence 201835 (RI)

Record details

NPI number1962375477
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 29, 2025
Last updated in NPPESDecember 25, 2025
Certification dateDecember 25, 2025
Mailing address806 Greenville Ave, Johnston, RI 02919-1305

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