Healthcare Provider Details

I. General information

NPI: 1902794696
Provider Name (Legal Business Name): ANDREW SWAIN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 BUTTONWOODS AVE
WARWICK RI
02886-7541
US

IV. Provider business mailing address

154 CAVALCADE BLVD
WARWICK RI
02889-1641
US

V. Phone/Fax

Practice location:
  • Phone: 401-732-9090
  • Fax:
Mailing address:
  • Phone: 401-626-2659
  • Fax: 401-626-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04113
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: