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Individual

HAROLD GOLDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
101 BACON ST, PAWTUCKET, RI 02860-5542
(401) 722-3560
(401) 722-3593
Mailing address
P.O. BOX 899, WAKEFIELD, RI 02879-2222
(401) 364-7705
(401) 364-7705

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050306183
MULTIPLAN
RI
01
1020890
BEACON NHP
RI
01
233232
TRICARE
RI
01
306186
BCBS
RI
01
406478
BLUE CHIP
RI
01
6234382
UBH
RI
01
A007959
VALUE OPTIONS
RI
05
HG13028
RI
01
RI0007930
CHAMPUS
RI
Enumeration date
10/27/2006
Last updated
07/08/2016
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