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Individual

KENDRA DIMINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
935 PARK AVE STE 206, CRANSTON, RI 02910-2748
(401) 439-0329
(401) 228-3030
Mailing address
935 PARK AVE STE 206, CRANSTON, RI 02910-2748
(401) 439-0329
(401) 228-3030

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01430
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29289-6
BLUE SHIELD PROVIDER #
RI
01
412739
BLUE CHIP PROVIDER #
RI
Enumeration date
06/12/2006
Last updated
10/14/2025
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