Provider Demographics
NPI:1861585630
Name:CALISE, JOANN D (APRN-CSR CNS)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:D
Last Name:CALISE
Suffix:
Gender:F
Credentials:APRN-CSR CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 BLACKSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4800
Mailing Address - Country:US
Mailing Address - Phone:401-455-6367
Mailing Address - Fax:401-455-6222
Practice Address - Street 1:345 BLACKSTONE BLVD
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4800
Practice Address - Country:US
Practice Address - Phone:401-455-6367
Practice Address - Fax:401-455-6222
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICAPRN00159364SP0809X
RIAPRN00159163WP0809X
RIRN21467163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI62-49102OtherUBH
RI406368OtherBLUE CHIP
RI30389-5OtherBLUE CROSS
RI007057583Medicare ID - Type Unspecified