Provider Demographics
NPI:1144377870
Name:DEE, NANCY ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:DEE
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 1:629 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-7618
Mailing Address - Country:US
Mailing Address - Phone:401-789-9989
Mailing Address - Fax:
Practice Address - Street 1:23 NORTH RD
Practice Address - Street 2:A25
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-2176
Practice Address - Country:US
Practice Address - Phone:401-864-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW001841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI3411-7OtherBLUE CROSS PROVIDER NO.
RI409236OtherBLUE CHIP PROVIDER NUMBER