Provider Demographics
NPI:1013381789
Name:CABLE, ADAM (LICSW)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:CABLE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 GOVERNOR ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3239
Mailing Address - Country:US
Mailing Address - Phone:401-408-4324
Mailing Address - Fax:401-347-1980
Practice Address - Street 1:208 GOVERNOR ST UNIT 2
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3239
Practice Address - Country:US
Practice Address - Phone:401-408-4324
Practice Address - Fax:401-347-1980
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW028051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical