Provider Demographics
NPI:1164613154
Name:GINA BREGGIA, LICSW
Entity Type:Organization
Organization Name:GINA BREGGIA, LICSW
Other - Org Name:GINA BREGGIA-PINE, LICSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BREGGIA-PINE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-944-2270
Mailing Address - Street 1:989 RESERVOIR AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-5138
Mailing Address - Country:US
Mailing Address - Phone:401-944-2270
Mailing Address - Fax:401-944-0026
Practice Address - Street 1:989 RESERVOIR AVE STE 9
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-5138
Practice Address - Country:US
Practice Address - Phone:401-944-2270
Practice Address - Fax:401-944-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI62-93351OtherUNITED HEALTH
RI31180-9OtherBLUE CROSS
RI413316OtherBLUE CHIP
RI2278859OtherCIGNA