MEDICARE: ROBIN BOYAJIAN 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	101YM0800X	Mental Health Counselor	ISW01127	RI
2	1041C0700X	Clinical Social Worker	ISW01127	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22891-6	OTHER	RI	BLUE SHIELD HMO
2	410576	OTHER	RI	BLUE CHIP COORDINATED HEA

General Provider Information

NPI Number	:	1720112287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN BOYAJIAN LICSW

Provider Business Mailing Address
First Line	:	137 BURBANK DR
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-3503
Country	:	US
Telephone Number	:	401-749-3301
Fax Number	:	401-773-7793

Provider Business Practice Location Address
First Line	:	2845 POST ROAD
Second Line	:	SUITE 113
City	:	WARWICK
State	:	RI
Zip	:	02886
Country	:	US
Telephone Number	:	401-749-3301
Fax Number	:	401-773-7793

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	10/25/2017

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Directions to “ ROBIN BOYAJIAN LICSW” Practice Location

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