Healthcare Provider Details

I. General information

NPI: 1932624517
Provider Name (Legal Business Name): JENNIFER ROSE PACE MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ROSE RIORDAN

II. Dates (important events)

Enumeration Date: 08/04/2017
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TOLL GATE RD STE 300
WARWICK RI
02886-4416
US

IV. Provider business mailing address

186 PROVIDENCE ST
WEST WARWICK RI
02893-2508
US

V. Phone/Fax

Practice location:
  • Phone: 401-467-0333
  • Fax:
Mailing address:
  • Phone: 401-767-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW02463
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW04541
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: