Individual
MR. GARY P. COURNOYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.I.C.S.W.
Contact information
Practice address
342 BROADWAY, NEWPORT, RI 02840-1736
(401) 842-1158
Mailing address
15 RIPTIDE ST, JAMESTOWN, RI 02835-2527
(401) 842-1158
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00061
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3860-1
R.I. BLUE CROSS
RI
01
—
ISW00061
R.I. INDEP. SOC. WORKER
RI
Enumeration date
11/15/2006
Last updated
07/15/2014
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