Provider Demographics
NPI:1659647022
Name:GREGOIRE, SARAH (LICSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GREGOIRE
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 1:39 MERCHANT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-2319
Mailing Address - Country:US
Mailing Address - Phone:401-230-7406
Mailing Address - Fax:401-574-2040
Practice Address - Street 1:39 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2319
Practice Address - Country:US
Practice Address - Phone:401-230-7406
Practice Address - Fax:401-574-2040
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW015761041C0700X
MA1208671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical