Healthcare Provider Details

I. General information

NPI: 1003778622
Provider Name (Legal Business Name): LINDSAY HILLENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BALD HILL RD
WARWICK RI
02886-1617
US

IV. Provider business mailing address

25 POTTERS AVE
WARWICK RI
02886-3043
US

V. Phone/Fax

Practice location:
  • Phone: 401-349-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04358
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: