Individual
BETHANY VIRGILIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1 RIVER ST, WAKEFIELD, RI 02879-3214
(401) 767-4100
Mailing address
1 RIVER ST, WAKEFIELD, RI 02879-3214
(401) 767-4100
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02199
RI
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001309701
MEDICARE PTAN
RI
05
—
BG59338
—
RI
05
—
BG5938
—
RI
Enumeration date
05/07/2007
Last updated
06/26/2025
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