Individual
STACEY ARRUDA-TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
249 ROOSEVELT AVE, SUITE 205, PAWTUCKET, RI 02860-2134
(401) 724-8400
(401) 365-1100
Mailing address
1516 ATWOOD AVE, JOHNSTON, RI 02919-3223
(401) 553-1031
(401) 454-0148
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW00871
RI
1041C0700X
Clinical Social Worker
Primary
ISW01891
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30343
BLUE CROSS CRISIS
RI
05
—
SA56205
—
RI
Enumeration date
01/31/2007
Last updated
04/08/2009
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