Healthcare Provider Details

I. General information

NPI: 1710840087
Provider Name (Legal Business Name): ELIZABETH EVELYN MARSHALL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 WASHINGTON ST
WEST WARWICK RI
02893-5176
US

IV. Provider business mailing address

8 BRINLEY ST APT 5
NEWPORT RI
02840-3293
US

V. Phone/Fax

Practice location:
  • Phone: 401-822-1360
  • Fax:
Mailing address:
  • Phone: 401-829-5798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04264
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: