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General NPI Number Information
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NPI Number | 1093935082
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Entity Type | Individual
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Provider Name | KERRIN LYNNE CHARPENTIER LICSW
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 480 METACOM AVE
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City | BRISTOL
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State | RI
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Zip | 02809-5119
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Country | US
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Telephone | 401-253-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 51 LINDESTA RD
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City | PAWTUCKET
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State | RI
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Zip | 02861-2556
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Country | US
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Telephone | 401-475-3498
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW02005
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License Number State | RI
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