Individual
MRS. JENNIFER E LAFORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW , MSW
Contact information
Practice address
530 N MAIN ST, PROVIDENCE, RI 02904-5762
(401) 276-4530
Mailing address
2440A MENDON RD, CUMBERLAND, RI 02864-3728
(401) 316-6319
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW01535
RI
1041C0700X
Clinical Social Worker
CSW01535
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MA04867
—
RI
Enumeration date
07/23/2015
Last updated
07/21/2022
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