Healthcare Provider Details

I. General information

NPI: 1114817897
Provider Name (Legal Business Name): JOE RUTH CELESTIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 DOUGLAS PIKE STE 220
SMITHFIELD RI
02917-1879
US

IV. Provider business mailing address

900 DOUGLAS PIKE STE 220
SMITHFIELD RI
02917-1879
US

V. Phone/Fax

Practice location:
  • Phone: 401-452-0123
  • Fax:
Mailing address:
  • Phone: 401-452-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04416
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: