Provider Demographics
NPI:1093587792
Name:COLWELL, WILLIAM PETER (LICSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PETER
Last Name:COLWELL
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:PETER
Other - Last Name:BATEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:127 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-1501
Mailing Address - Country:US
Mailing Address - Phone:401-533-7455
Mailing Address - Fax:
Practice Address - Street 1:127 PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1501
Practice Address - Country:US
Practice Address - Phone:401-533-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI038321041C0700X
RIISW038921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical