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Individual

CHRISTOPHER M DORVAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
1524 ATWOOD AVE STE 244, JOHNSTON, RI 02919-3228
(401) 626-0169
Mailing address
64 EMERALD WAY, NORTH SCITUATE, RI 02857-2860
(401) 626-0169

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17440
MA
101YA0400X
Addiction (Substance Use Disorder) Counselor
200020
RI
1041C0700X
Clinical Social Worker
224236
MA
1041C0700X
Clinical Social Worker
Primary
ISW02895
RI

Other

Enumeration date
04/11/2012
Last updated
12/17/2020
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