Provider Demographics
NPI:1144253519
Name:POWERS, MARTHA (LICSW)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RICHMOND SQ STE 218W
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5136
Mailing Address - Country:US
Mailing Address - Phone:401-837-1800
Mailing Address - Fax:401-751-0126
Practice Address - Street 1:1 RICHMOND SQ STE 218W
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5136
Practice Address - Country:US
Practice Address - Phone:401-837-1800
Practice Address - Fax:401-751-0126
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW011671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical