Provider Demographics
NPI:1891094728
Name:RIBB, HALEY KATHRYN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:HALEY
Middle Name:KATHRYN
Last Name:RIBB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 FRUIT HILL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-2626
Mailing Address - Country:US
Mailing Address - Phone:401-353-3900
Mailing Address - Fax:
Practice Address - Street 1:420 FRUIT HILL AVE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2626
Practice Address - Country:US
Practice Address - Phone:401-353-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW016251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical