Individual
ALIX STOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
100 LAFAYETTE ST, SUITE 103, PAWTUCKET, RI 02860-6008
(401) 480-3434
Mailing address
PO BOX 603068, PROVIDENCE, RI 02906-0068
(401) 480-3434
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1017953
MA
1041C0700X
Clinical Social Worker
Primary
ISW00253
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029030
NHP/BEACON
—
01
—
23622-9
BLUE CROSS BLUE SHIELD
RI
01
—
409254
BLUE CHIP
—
01
—
6230482
UNITED HEALTH
—
05
—
AS19612
—
RI
Enumeration date
03/21/2006
Last updated
06/27/2008
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