MEDICARE: MRS. LINDA B MARCHETTI 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	104100000X	Social Worker	LSW00333	RI

General Provider Information

NPI Number	:	1700919545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA B MARCHETTI LICSW

Provider Business Mailing Address
First Line	:	63 SOCKANOSSET CROSS RD
Second Line	:	STE 1-B
City	:	CRANSTON
State	:	RI
Zip	:	02920-5557
Country	:	US
Telephone Number	:	401-228-8930
Fax Number	:	401-228-8710

Provider Business Practice Location Address
First Line	:	63 SOCKANOSSET CROSS RD
Second Line	:	STE 1-B
City	:	CRANSTON
State	:	RI
Zip	:	02920-5557
Country	:	US
Telephone Number	:	401-228-8930
Fax Number	:	401-228-8710

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	03/08/2013

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