Provider Demographics
NPI:1710046917
Name:RICE, PATRICIA ELLEN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ELLEN
Last Name:RICE
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 1:950 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1039
Mailing Address - Country:US
Mailing Address - Phone:617-244-9478
Mailing Address - Fax:
Practice Address - Street 1:53 LANGLEY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-1913
Practice Address - Country:US
Practice Address - Phone:617-244-0196
Practice Address - Fax:617-244-0196
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1112471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP08160OtherBCBSMA
MA221287OtherCOM PSYCH
MA1859455Medicaid
MA221287OtherCOM PSYCH