Healthcare Provider Details

I. General information

NPI: 1225904410
Provider Name (Legal Business Name): KAWEH DIAS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 BACON ST
PAWTUCKET RI
02860-5542
US

IV. Provider business mailing address

15 LA SALLE SQ
PROVIDENCE RI
02903-1814
US

V. Phone/Fax

Practice location:
  • Phone: 401-722-3560
  • Fax: 401-722-5280
Mailing address:
  • Phone: 401-444-6779
  • Fax: 401-444-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04348
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: