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NPI 1144253519

NPI 1144253519 : MARTHA POWERS LICSW : PROVIDENCE, RI

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General NPI Number Information
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    NPI Number           |    1144253519
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    Entity Type          |    Individual 
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    Provider Name        |    MARTHA POWERS LICSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/09/2006
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    Last Update Date     |    04/24/2024
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Provider Practice Location Address
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    Address Line         |    1 RICHMOND SQ STE 218W 
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    City                 |    PROVIDENCE
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    State                |    RI
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    Zip                  |    02906-5136
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    Country              |    US
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    Telephone            |    401-837-1800
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    Fax                  |    401-751-0126
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Provider Business Mailing Address
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    Address Line         |    1 RICHMOND SQ STE 218W 
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    City                 |    PROVIDENCE
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    State                |    RI
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    Zip                  |    02906-5136
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    Country              |    US
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    Telephone            |    401-837-1800
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    Fax                  |    401-751-0126
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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       |    ISW01167
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    License Number State |    RI
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