Healthcare Provider Details

I. General information

NPI: 1710772595
Provider Name (Legal Business Name): HALEY SCHUTZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 KILVERT ST
WARWICK RI
02886-1370
US

IV. Provider business mailing address

125 RESERVOIR RD
COVENTRY RI
02816-6412
US

V. Phone/Fax

Practice location:
  • Phone: 401-618-6991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04011
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: