Provider Demographics
NPI:1457661076
Name:DI PADUA, LYNNE M (LCSW)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:M
Last Name:DI PADUA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-1612
Mailing Address - Country:US
Mailing Address - Phone:401-954-0990
Mailing Address - Fax:888-850-8554
Practice Address - Street 1:3 MICHAEL ST
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-6212
Practice Address - Country:US
Practice Address - Phone:401-954-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-16
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW013351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical