Individual
MRS. KATHLEEN ANN CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
103 BACON ST, PAWTUCKET, RI 02860
(401) 722-3560
(401) 722-3593
Mailing address
97 WOOD ST, COVENTRY, RI 02816
(401) 821-9559
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01175
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300960
BLUE CROSS
—
01
—
406936
BLUE CHIP
—
01
—
6262761
UBH
—
05
—
KB13099
—
RI
Enumeration date
04/01/2006
Last updated
07/08/2007
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