Provider Demographics
NPI:1801915285
Name:CHICK, DEBORAH A (LICSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:CHICK
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 1:100 MEDWAY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4402
Mailing Address - Country:US
Mailing Address - Phone:401-421-4100
Mailing Address - Fax:401-454-5565
Practice Address - Street 1:100 MEDWAY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4402
Practice Address - Country:US
Practice Address - Phone:401-421-4100
Practice Address - Fax:401-454-5565
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW 004881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI3249683OtherAETNA
RIDC 03156Medicaid
RI62-32271OtherUNITED HEALTH CARE
RI1021010OtherBEACON
RI30237-5OtherBLUE CROSS BLUE SHIELD
RI406376OtherBLUE CHIP