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NPI Code Detail

MEDICARE: ROSE A GOULET LICSW

MEDICARE: ROSE A GOULET 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
11041C0700XClinical Social WorkerISW01046RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130018-4OTHERRIBLUE CROSS
262-42870OTHERRIUBH
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4407468OTHERRIBLUE CHIP

General Provider Information

NPI Number : 1356326854
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE A GOULET LICSW
Provider Business Mailing Address
First Line : 1 CURT ST
Second Line :
City : SEEKONK
State : MA
Zip : 02771-5007
Country : US
Telephone Number : 401-431-9870
Fax Number :
Provider Business Practice Location Address
First Line : 610 WAMPANOAG TRL
Second Line :
City : EAST PROVIDENCE
State : RI
Zip : 02915-1504
Country : US
Telephone Number : 401-431-9870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 10/10/2007

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1720068521 — STEVE BERUBE LICSW
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1558319731 — MR. KENNETH ARNOLD WEEDEN JR. L.C.D.P. , C.C.D.P.D
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1093662363 — X
Practice Location Address:
5 WOODLAWN AVE
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02911-1504
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Directions to “ ROSE A GOULET LICSW” Practice Location

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