Provider Demographics
NPI:1326097247
Name:CURRAN, EILEEN (LICSW)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:CURRAN
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 1:47 BURTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-4228
Mailing Address - Country:US
Mailing Address - Phone:401-252-1468
Mailing Address - Fax:
Practice Address - Street 1:340 BROADWAY
Practice Address - Street 2:HILLSIDE AVENUE FAMILY AND COMMUNITY MEDICAL
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1102
Practice Address - Country:US
Practice Address - Phone:401-252-1468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW015691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIEC51426Medicaid
RIEC51426Medicaid