Healthcare Provider Details

I. General information

NPI: 1366469124
Provider Name (Legal Business Name): ALICE R. ZORY LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

989 RESERVOIR AVE STE 101
CRANSTON RI
02910-5138
US

IV. Provider business mailing address

10 DAVOL SQ STE 400
PROVIDENCE RI
02903-4752
US

V. Phone/Fax

Practice location:
  • Phone: 401-572-3313
  • Fax:
Mailing address:
  • Phone: 401-421-4000
  • Fax: 401-272-1456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW00978
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: