Healthcare Provider Details

I. General information

NPI: 1922245620
Provider Name (Legal Business Name): SARAH A OSTROM LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2009
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 TIOGUE AVE STE A
COVENTRY RI
02816-6397
US

IV. Provider business mailing address

960 TIOGUE AVE STE A
COVENTRY RI
02816-6397
US

V. Phone/Fax

Practice location:
  • Phone: 401-326-5989
  • Fax: 401-269-0797
Mailing address:
  • Phone: 401-326-5929
  • Fax: 401-269-0797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW01792
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: