Individual
ANTHONY MICHAEL MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1020 PARK AVE, STE 105, CRANSTON, RI 02910-3227
(401) 944-9659
(401) 944-9859
Mailing address
1020 PARK AVE, STE 105, CRANSTON, RI 02910-3227
(401) 944-9659
(401) 944-9859
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00290
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3369-7
BLUE CROSS
RI
01
—
406568
BLUE CHIP
RI
01
—
62-46448
UNITED BEHAVIORAL HEALTH
RI
05
—
AM01505
—
RI
Enumeration date
06/06/2006
Last updated
01/15/2021
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