Provider Demographics
NPI:1467403097
Name:RAJABIUN, DAVID (LICSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:RAJABIUN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BLACKSTONE VALLEY PL
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1145
Mailing Address - Country:US
Mailing Address - Phone:401-334-1830
Mailing Address - Fax:401-334-1833
Practice Address - Street 1:8 BLACKSTONE VALLEY PL
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1145
Practice Address - Country:US
Practice Address - Phone:401-334-1830
Practice Address - Fax:401-334-1833
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW015441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical