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Individual

TINA A. LEAVITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
989 RESERVOIR AVE STE 203, CRANSTON, RI 02910-5138
(401) 414-7888
Mailing address
989 RESERVOIR AVE STE 203, CRANSTON, RI 02910-5138
(014) 147-8884
(401) 638-1740

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02932
RI
1041C0700X
Clinical Social Worker
LICSW124585
MA

Other

Enumeration date
08/12/2019
Last updated
07/15/2024
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