MEDICARE: GENESIS MOREL LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	ISW03725	RI

General Provider Information

NPI Number	:	1316596661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENESIS MOREL LICSW

Provider Business Mailing Address
First Line	:	171 SERVICE AVE
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-1014
Country	:	US
Telephone Number	:	401-430-2000
Fax Number	:	401-453-7597

Provider Business Practice Location Address
First Line	:	171 SERVICE AVE
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-1014
Country	:	US
Telephone Number	:	401-430-2000
Fax Number	:	401-453-7597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2019
Last Update Date	:	06/17/2025

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Directions to “ GENESIS MOREL LICSW” Practice Location

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