Individual
MS. COLETTE THERESA LAFOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W.
Contact information
Practice address
747 AQUIDNECK AVE, MIDDLETOWN, RI 02842-7265
(401) 846-1213
(401) 848-9151
Mailing address
55 EVERGREEN DR, PORTSMOUTH, RI 02871-2214
(401) 848-2964
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01191
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
408132
BLUE CROSS PROVIDER
RI
01
—
62-54314
UNITED BEHAVIORAL PROVIDE
RI
05
—
CL04809
—
RI
Enumeration date
05/04/2006
Last updated
05/23/2016
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