Healthcare Provider Details

I. General information

NPI: 1740137405
Provider Name (Legal Business Name): MRS. LAUREN CALLAHAN MASSARONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 W RIVER PKWY
NORTH PROVIDENCE RI
02904-3417
US

IV. Provider business mailing address

15 W RIVER PKWY
NORTH PROVIDENCE RI
02904-3417
US

V. Phone/Fax

Practice location:
  • Phone: 508-304-3151
  • Fax:
Mailing address:
  • Phone: 401-830-9970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW04749
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: