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NPI Code Detail

MEDICARE: CHRISTINE L ENOS LICSW

MEDICARE: CHRISTINE L ENOS LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerISW01257RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ISW01257OTHERRISOCIAL WORK LICENSE
262-59567OTHERRIUNITED BEHAVIORAL HEALTH
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
430015-7OTHERBLUE CROSS
5407210OTHERRIBLUE CHIP

General Provider Information

NPI Number : 1285611814
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE L ENOS LICSW
Provider Business Mailing Address
First Line : 78 BELMONT AVE
Second Line :
City : EAST PROVIDENCE
State : RI
Zip : 02914-3906
Country : US
Telephone Number : 401-435-4147
Fax Number :
Provider Business Practice Location Address
First Line : 610 WAMPANOAG TRL
Second Line :
City : EAST PROVIDENCE
State : RI
Zip : 02915-1504
Country : US
Telephone Number : 401-431-9870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 10/20/2009

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Directions to “ CHRISTINE L ENOS LICSW” Practice Location

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