Healthcare Provider Details

I. General information

NPI: 1629458047
Provider Name (Legal Business Name): CAITLIN S LAWRENCE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 BLACKSTONE BLVD
PROVIDENCE RI
02906-4800
US

IV. Provider business mailing address

100 TAUNTON ST. UNIT A317
PLAINVILLE MA
02762
US

V. Phone/Fax

Practice location:
  • Phone: 401-455-6200
  • Fax: 401-455-6689
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD16450
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD16450
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: