Individual
CRISTINA M COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1240 PAWTUCKET AVE STE 3, RUMFORD, RI 02916-1431
(401) 400-2023
Mailing address
PO BOX 41335, PROVIDENCE, RI 02940-1335
(401) 952-3627
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
120668
MA
1041C0700X
Clinical Social Worker
Primary
220041
MA
1041C0700X
Clinical Social Worker
CSW01757
RI
1041S0200X
School Social Worker
70412
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306952312
—
RI
05
—
1972662104
—
RI
Enumeration date
09/29/2014
Last updated
01/11/2021
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