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General NPI Number Information
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NPI Number | 1649243981
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Entity Type | Individual
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Provider Name | KATHRYN B EDEN MSW LICSW
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 1 RICHMOND SQ STE 128C
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City | PROVIDENCE
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State | RI
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Zip | 02906-5140
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Country | US
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Telephone | 401-548-8733
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Fax |
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Provider Business Mailing Address
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Address Line | 159 BAY STATE RD
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City | REHOBOTH
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State | MA
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Zip | 02769-1738
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Country | US
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Telephone | 401-301-2006
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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 | 1021862
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 108014
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 15W01525
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License Number State | RI
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