Provider Demographics
NPI:1851621221
Name:CHICK, JUDITH HILL (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:HILL
Last Name:CHICK
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 1:106 LAURI DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02813-3644
Mailing Address - Country:US
Mailing Address - Phone:401-348-5035
Mailing Address - Fax:401-348-5035
Practice Address - Street 1:3949 OLD POST RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02813-2599
Practice Address - Country:US
Practice Address - Phone:401-477-2664
Practice Address - Fax:401-348-5035
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW008651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical