Provider Demographics
NPI:1699814806
Name:JOHN B LINDA B MARCHETTI INC
Entity Type:Organization
Organization Name:JOHN B LINDA B MARCHETTI INC
Other - Org Name:JOHN G MARCHETTI JR LINDA B MARCHATTI
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MARCHETTI
Authorized Official - Suffix:JR
Authorized Official - Credentials:LICSW ACSW
Authorized Official - Phone:401-739-4969
Mailing Address - Street 1:390 TOLL GATE RD STE K104
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4326
Mailing Address - Country:US
Mailing Address - Phone:401-739-4969
Mailing Address - Fax:401-739-5158
Practice Address - Street 1:390 TOLL GATE RD STE K104
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4326
Practice Address - Country:US
Practice Address - Phone:401-739-4969
Practice Address - Fax:401-739-5158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILSW00332104100000X
RILSW00333104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty