MEDICARE: CLYDE ANTONIO HILLIARD

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1316648819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLYDE ANTONIO HILLIARD

Provider Business Mailing Address
First Line	:	28 AUGUST ST
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02908-2905
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 AUGUST ST
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02908-2905
Country	:	US
Telephone Number	:	401-263-1203
Fax Number	:

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

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	02/13/2026

Similar Medicare Providers

1982551248 — SOULFUL HEALING AND WELLNESS LLC
Practice Location Address:

28 AUGUST ST
PROVIDENCE, RI
02908-2905

Practice Phone: 401-263-1203
Practice Fax:

1164935862 — CONCIERGE PHYSICAL THERAPY, INC.
Practice Location Address:

211 WORCESTER PROVIDENCE TPKE
SUTTON, MA
01590-2905

Practice Phone: 508-861-1010
Practice Fax:

1033675145 — DR. MARK A CELIO PHD
Practice Location Address:

121 S MAIN ST
PROVIDENCE, RI
02903-2905

Practice Phone: 401-863-6662
Practice Fax:

1265313944 — CONNOR HUME
Practice Location Address:

211 WORCESTER PROVIDENCE TPKE
SUTTON, MA
01590-2905

Practice Phone: 508-861-1010
Practice Fax:

1962441543 — LAURA MAGAN MD
Practice Location Address:

830 CHALKSTONE AVE
PROVIDENCE, RI
02908-4734

Practice Phone: 401-273-7100
Practice Fax:

1851248207 — ANEZTI AND SONS LLC
Practice Location Address:

56 DURHAM ST
PROVIDENCE, RI
02908-1523

Practice Phone: 401-808-5321
Practice Fax:

Directions to “ CLYDE ANTONIO HILLIARD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.