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General NPI Number Information
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NPI Number | 1356451710
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Entity Type | Individual
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Provider Name | JOAN A SOUZA MSW LICSW
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 12/13/2017
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Provider Practice Location Address
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Address Line | 1 RICHMOND SQUARE SUITE 232E
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City | PROVIDENCE
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State | RI
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Zip | 02906-4318
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Country | US
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Telephone | 401-273-4999
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Fax | 401-273-4999
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Provider Business Mailing Address
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Address Line | 1 RICHMOND SQUARE SUITE 232E
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City | PROVIDENCE
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State | RI
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Zip | 02906-4318
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Country | US
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Telephone | 401-273-4999
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Fax | 401-273-9999
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 110419
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ISW01249
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License Number State | RI
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