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General NPI Number Information
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NPI Number | 1770760993
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Entity Type | Organization
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Legal Business Name | GROUP BY DESIGN, LLP
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 1 RICHMOND SQ SUITE 122C
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City | PROVIDENCE
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State | RI
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Zip | 02906-5139
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Country | US
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Telephone | 401-454-2890
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Fax | 401-351-8020
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Provider Business Mailing Address
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Address Line | 1 RICHMOND SQ SUITE 122C
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City | PROVIDENCE
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State | RI
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Zip | 02906-5139
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Country | US
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Telephone | 401-454-2890
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Fax | 401-351-8020
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | DANIEL M EVEN
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Credential | MDIV, MSW
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Telephone | 401-454-2890
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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 | ISW00186
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License Number State | RI
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