Individual
MS. MICHELLE A MATHIESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01689
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032430
NEIGHBORHOOD HEALTH PLAN
RI
01
—
29590-9
BLUE CROSS/BLUE SHIELD
RI
01
—
412646
BLUE CHIP
RI
05
—
MM54608
—
RI
05
—
MM59098
—
RI
Enumeration date
05/15/2006
Last updated
03/30/2026
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