Healthcare Provider Details

I. General information

NPI: 1427978774
Provider Name (Legal Business Name): MR. SEGUERRE MICHEL JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 ROBINSON ST
WOONSOCKET RI
02895-2123
US

IV. Provider business mailing address

37 ROBINSON ST
WOONSOCKET RI
02895-2123
US

V. Phone/Fax

Practice location:
  • Phone: 774-223-0717
  • Fax:
Mailing address:
  • Phone: 774-223-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04368
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: