Healthcare Provider Details

I. General information

NPI: 1114198140
Provider Name (Legal Business Name): MARIE PALUMBO-HAYES LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HOPE ST
PROVIDENCE RI
02906-2001
US

IV. Provider business mailing address

55 HOPE ST
PROVIDENCE RI
02906-2001
US

V. Phone/Fax

Practice location:
  • Phone: 401-952-6697
  • Fax:
Mailing address:
  • Phone: 401-952-9967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1017371
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number1018371
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: