Provider Demographics
NPI:1619169067
Name:PATTISON, LORI (LICSW)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:PATTISON
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 1:191 SOCIAL ST
Mailing Address - Street 2:SUITE 590
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3240
Mailing Address - Country:US
Mailing Address - Phone:401-769-4373
Mailing Address - Fax:401-769-0397
Practice Address - Street 1:191 SOCIAL ST
Practice Address - Street 2:SUITE 590
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3240
Practice Address - Country:US
Practice Address - Phone:401-769-4373
Practice Address - Fax:401-769-0397
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW020411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical