Individual
MISS KELLI RIVELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1126 HARTFORD AVE, SUITE 101, JOHNSTON, RI 02919-7130
(401) 351-2750
(401) 351-7002
Mailing address
1126 HARTFORD AVE, SUITE 101, JOHNSTON, RI 02919-7130
(401) 351-2750
(401) 351-7002
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
L.C.D.P. # NOT RCVD
RI
1041C0700X
Clinical Social Worker
Primary
ISW04259
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TT24187
—
RI
Enumeration date
10/02/2006
Last updated
11/05/2024
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