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General NPI Number Information
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NPI Number | 1871384693
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Entity Type | Individual
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Provider Name | CECILY SHANNON O'LEARY LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 1045 WARWICK AVE STE 101
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City | WARWICK
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State | RI
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Zip | 02888-3657
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Country | US
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Telephone | 401-480-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 55 N SHORE DR UNIT 2
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City | RIVERSIDE
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State | RI
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Zip | 02915-2905
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Country | US
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Telephone | 978-257-3927
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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 | LCSW231054
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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 | CSW03958
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License Number State | RI
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