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Individual

MILDRED BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
55 HOPE ST, FAMILY SERVICE OF RHODE ISLAND, PROVIDENCE, RI 02906-2001
(401) 331-1350
(401) 277-3366
Mailing address
34 HART ST, PROVIDENCE, RI 02906-2632
(401) 331-1350
(401) 277-3366

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01713
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05025885815
PACIFICARE
01
1021740
GROUP NUMBER NHP
01
12400210
MULTIPLAN
01
26595-7
BLUE CROSS BLUE SHIELD
01
410724
BLUE CHIP
05
MB321125
RI
Enumeration date
01/09/2007
Last updated
07/08/2007
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