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General NPI Number Information
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NPI Number | 1932801040
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Entity Type | Individual
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Provider Name | LAURA ANN GOMES LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 66 BURNETT ST
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City | PROVIDENCE
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State | RI
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Zip | 02907-2527
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Country | US
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Telephone | 401-785-0050
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Fax |
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Provider Business Mailing Address
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Address Line | 17 DORR DR
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City | CHEPACHET
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State | RI
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Zip | 02814-4427
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Country | US
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Telephone | 401-651-8839
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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 | CSW02935
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License Number State | RI
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