Healthcare Provider Details

I. General information

NPI: 1902794696
Provider Name (Legal Business Name): ANDREW SWAIN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 DORIC AVE
CRANSTON RI
02910-2903
US

IV. Provider business mailing address

311 DORIC AVE
CRANSTON RI
02910-2903
US

V. Phone/Fax

Practice location:
  • Phone: 401-467-9610
  • Fax: 401-467-9030
Mailing address:
  • Phone: 401-467-9610
  • Fax: 401-467-9030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04113
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: