Individual
MS. NANCY CAROL HETHERINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01151
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26586-3
PSYCHOTHERAPIST
RI
01
—
410721
PSYCHOTHERAPIST
RI
01
—
62-83298
PSYCHOTHERAPIST
RI
01
—
8090041211
MEDICARE PTAN
RI
05
—
9004121
—
RI
Enumeration date
08/05/2006
Last updated
07/25/2013
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