Provider Demographics
NPI:1629014865
Name:FAMILY SERVICE SOCIETY OF PAWTUCKET & VICINITY
Entity Type:Organization
Organization Name:FAMILY SERVICE SOCIETY OF PAWTUCKET & VICINITY
Other - Org Name:FAMILY SERVICE SOCIETY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, DCSW
Authorized Official - Phone:401-723-2124
Mailing Address - Street 1:33 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-2964
Mailing Address - Country:US
Mailing Address - Phone:401-723-2124
Mailing Address - Fax:401-723-0566
Practice Address - Street 1:33 SUMMER ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-2964
Practice Address - Country:US
Practice Address - Phone:401-723-2124
Practice Address - Fax:401-723-0566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty