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General NPI Number Information
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NPI Number | 1699814806
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Entity Type | Organization
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Legal Business Name | JOHN B LINDA B MARCHETTI INC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 390 TOLL GATE RD STE K104
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City | WARWICK
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State | RI
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Zip | 02886-4326
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Country | US
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Telephone | 401-739-4969
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Fax | 401-739-5158
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Provider Business Mailing Address
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Address Line | 390 TOLL GATE RD STE K104
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City | WARWICK
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State | RI
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Zip | 02886-4326
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Country | US
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Telephone | 401-739-4969
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Fax | 401-739-5158
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN B MARCHETTI JR.
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Credential | LICSW ACSW
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Telephone | 401-739-4969
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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 | LSW00333
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License Number State | RI
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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 | LSW00332
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License Number State | RI
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