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NPI Code Detail

MEDICARE: BRYDIE THOMASIAN LICSW

MEDICARE: BRYDIE THOMASIAN 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 WorkerISW02122RI

General Provider Information

NPI Number : 1861516361
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYDIE THOMASIAN LICSW
Provider Business Mailing Address
First Line : 455 TOLL GATE RD
Second Line :
City : WARWICK
State : RI
Zip : 02886-2759
Country : US
Telephone Number : 401-273-0641
Fax Number : 401-273-2919
Provider Business Practice Location Address
First Line : 455 TOLL GATE RD
Second Line :
City : WARWICK
State : RI
Zip : 02886-2759
Country : US
Telephone Number : 401-737-7010
Fax Number : 401-736-4546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 12/02/2025

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Directions to “ BRYDIE THOMASIAN LICSW” Practice Location

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