Provider Demographics
NPI:1447402110
Name:HAMEL, JESSICA A (LICSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:HAMEL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:A
Other - Last Name:BONANNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1045 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3665
Mailing Address - Country:US
Mailing Address - Phone:401-486-6793
Mailing Address - Fax:401-347-1738
Practice Address - Street 1:1045 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3665
Practice Address - Country:US
Practice Address - Phone:401-486-6793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW022891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical