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General NPI Number Information
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NPI Number | 1609738483
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Entity Type | Individual
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Provider Name | TIMOTHY DONALD LAPRADE LICSW
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Gender | Male
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1524 ATWOOD AVE STE 244
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City | JOHNSTON
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State | RI
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Zip | 02919-3228
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Country | US
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Telephone | 401-696-1507
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Fax |
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Provider Business Mailing Address
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Address Line | 51 COLONIAL RD
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City | BURRILLVILLE
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State | RI
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Zip | 02830-1222
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Country | US
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Telephone | 401-696-1507
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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 | ISW04666
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License Number State | RI
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