Provider Demographics
NPI:1093850406
Name:AGINS, PAULA M (LICSW)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:M
Last Name:AGINS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 GREENMAN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891
Mailing Address - Country:US
Mailing Address - Phone:401-596-1858
Mailing Address - Fax:
Practice Address - Street 1:97 CROSS ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2448
Practice Address - Country:US
Practice Address - Phone:401-527-8502
Practice Address - Fax:401-315-5569
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW01624104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIPA58337Medicaid
RI291086OtherBLUE CROSS SHIELD