Provider Demographics
NPI:1275655946
Name:NORMA L. WELITOFF ,LICSW
Entity Type:Organization
Organization Name:NORMA L. WELITOFF ,LICSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:WELITOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-378-7878
Mailing Address - Street 1:32 GRANDEVILLE CT
Mailing Address - Street 2:APT. #1037
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-8211
Mailing Address - Country:US
Mailing Address - Phone:401-378-7878
Mailing Address - Fax:401-294-3030
Practice Address - Street 1:1130 TEN ROD RD
Practice Address - Street 2:BLDG E SUITE 206B
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4161
Practice Address - Country:US
Practice Address - Phone:401-378-7878
Practice Address - Fax:401-294-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW012531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI345085OtherTRICARE
RINW48009Medicaid
RI1032500OtherNHPRC
RI209045OtherBCBS
RI345085OtherTRICARE