=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225904410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAWEH DIAS LCSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2025
-----------------------------------------------------
Last Update Date | 11/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 105 BACON ST
-----------------------------------------------------
City | PAWTUCKET
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02860-5542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-722-3560
-----------------------------------------------------
Fax | 401-722-5280
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15 LA SALLE SQ
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02903-1814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-444-6779
-----------------------------------------------------
Fax | 401-444-6912
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CSW04348
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------