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General NPI Number Information
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NPI Number | 1396329850
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Entity Type | Individual
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Provider Name | CHEYENNE L LEARD LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 05/11/2021
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Provider Practice Location Address
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Address Line | 25 W INDEPENDENCE WAY # 1127
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City | KINGSTON
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State | RI
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Zip | 02881-1126
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Country | US
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Telephone | 401-789-4614
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Fax |
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Provider Business Mailing Address
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Address Line | 98 MERRITT AVE
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City | TIVERTON
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State | RI
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Zip | 02878-1622
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Country | US
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Telephone | 401-440-4606
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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 | CSW02527
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License Number State | RI
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