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Individual

CAREN PRIDEAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
176 SUMMIT ST, EAST PROVIDENCE, RI 02914-4422
(401) 569-7786
Mailing address
176 SUMMIT ST, EAST PROVIDENCE, RI 02914-4422
(401) 569-7786

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01679
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30983-3
BLUE CROSS
RI
01
413122
BLUE CHIP
RI
01
62-47773
UNITED BEHAVIORAL HEALTH
RI
05
CP58572
RI
Enumeration date
06/01/2006
Last updated
10/23/2009
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