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General NPI Number Information
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NPI Number | 1710532817
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Entity Type | Individual
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Provider Name | ROBERT WILLIAM MACDONALD JR. LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/06/2019
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 200 HIGH SERVICE AVE
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-5113
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Country | US
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Telephone | 401-456-3034
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Fax | 401-752-8116
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Provider Business Mailing Address
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Address Line | 416 ACADEMY AVE
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City | PROVIDENCE
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State | RI
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Zip | 02908-4100
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Country | US
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Telephone | 401-499-0299
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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 | ISW03250
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License Number State | RI
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