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General NPI Number Information
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NPI Number | 1902413701
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Entity Type | Individual
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Provider Name | ANDREW LEONARD LICSW
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Gender | Male
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 04/20/2025
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Provider Practice Location Address
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Address Line | 410 N BROADWAY
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-2025
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Country | US
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Telephone | 401-320-4458
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Fax | 401-340-1572
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Provider Business Mailing Address
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Address Line | 85 KIMBERLY DR
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City | WEST GREENWICH
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State | RI
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Zip | 02817-2001
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Country | US
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Telephone | 401-543-7971
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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 | ISW03049
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License Number State | RI
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