Provider Demographics
NPI:1144258468
Name:CAREY, WILLIAM S (LICSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:S
Last Name:CAREY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-1133
Mailing Address - Country:US
Mailing Address - Phone:401-699-4288
Mailing Address - Fax:401-632-0993
Practice Address - Street 1:322 BROADWAY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1133
Practice Address - Country:US
Practice Address - Phone:401-699-4288
Practice Address - Fax:401-632-0993
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW015051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIWC32313Medicaid
RI31095-0OtherBLUE CROSS
RI413194OtherBLUE CHIP
RI62-22848OtherUNITED BEHAVIORAL HEALTH
RI62-22848OtherUNITED BEHAVIORAL HEALTH