Individual
ANDREA G DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1 RICHMOND SQ STE 300E, PROVIDENCE, RI 02906-5160
(401) 349-3131
Mailing address
1 RICHMOND SQ STE 300E, PROVIDENCE, RI 02906-5160
(401) 349-3131
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01279
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
299121
BLUE CROSS
RI
01
—
412887
BLUE CHIP
RI
Enumeration date
10/02/2006
Last updated
12/15/2025
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