Provider Demographics
NPI:1679189310
Name:TOKARSKI, KATHLEEN M (LICSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:TOKARSKI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:TOKARSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:43 BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-1977
Mailing Address - Country:US
Mailing Address - Phone:401-596-5302
Mailing Address - Fax:
Practice Address - Street 1:43 BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-1977
Practice Address - Country:US
Practice Address - Phone:401-596-2302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW015511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical