Healthcare Provider Details

I. General information

NPI: 1558884759
Provider Name (Legal Business Name): SHEHERAZADE RITCHIE PLYNTON LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARA RITCHIE PLYNTON LICSW

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 07/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 POST RD
WARWICK RI
02888-3363
US

IV. Provider business mailing address

278 LAFAYETTE ST
PAWTUCKET RI
02860-6016
US

V. Phone/Fax

Practice location:
  • Phone: 401-785-0040
  • Fax:
Mailing address:
  • Phone: 401-523-1497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW01181
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: