Healthcare Provider Details

I. General information

NPI: 1982596482
Provider Name (Legal Business Name): BIANCA LABELLA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 RESERVOIR AVE STE 3K
PROVIDENCE RI
02907-3565
US

IV. Provider business mailing address

41 N WILLIAMS ST
JOHNSTON RI
02919-5146
US

V. Phone/Fax

Practice location:
  • Phone: 401-400-2826
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number82402
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW03755
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: