Individual
DIANE HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
4705 OLD POST RD UNIT A, CHARLESTOWN, RI 02813-1842
(401) 789-1367
(401) 364-3310
Mailing address
PO BOX 899, CHARLESTOWN, RI 02813-0899
(401) 364-7705
(401) 364-3310
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00904
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699824748
BLUE CROSS BLUE SHIELD RI
RI
01
—
709001889
MEDICARE GATEWAY HEALTHCARE
RI
05
—
DH03900
—
RI
Enumeration date
01/09/2007
Last updated
04/21/2016
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