Provider Demographics
NPI:1508165408
Name:CLINICAL ASSESSMENT AND CONSULTATION
Entity Type:Organization
Organization Name:CLINICAL ASSESSMENT AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PH.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUWORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-624-7281
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:1061 FISH ROAD
Mailing Address - City:TIVERTON
Mailing Address - State:RI
Mailing Address - Zip Code:02878-0272
Mailing Address - Country:US
Mailing Address - Phone:401-624-7281
Mailing Address - Fax:401-624-7208
Practice Address - Street 1:400 NATHAN ELLIS HWY
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02878-0272
Practice Address - Country:US
Practice Address - Phone:401-624-7281
Practice Address - Fax:401-624-7208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00671103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty