is a Clinical in Charlestown, Rhode Island. practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1881744803. The last update date is .
's current location address is 4705a Old Post Rd, Charlestown, Rhode Island. You can contact this provider via phone number 4013647705 and fax number 4013649104. The mailing address for is 4705a Old Post Rd, Charlestown, Rhode Island. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 4705a Old Post Rd, Charlestown, Rhode Island |
| Phone Number | 4013647705 |
| Fax Number | 4013649104 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1881744803 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 4705a Old Post Rd |
|---|---|
| City | Charlestown |
| State | Rhode Island (RI) |
| Post Code | 28131819 |
| Phone Number | 4013647705 |
| Fax Number | 4013649104 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | CSW00804 |
|
Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| KR55307 | RI | -- | |
| 1020890 | RI | BEACON | |
| 29234 | RI | BLUE CROSS | |
| 50306183 | RI | MAGELLAN | |
| 412333 | RI | BLUE CHIP |
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