Provider Demographics
NPI:1922581743
Name:BRYANT, PATRICIA EWART (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:EWART
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ACRE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-2701
Mailing Address - Country:US
Mailing Address - Phone:401-289-2333
Mailing Address - Fax:
Practice Address - Street 1:201 ARMISTICE BLVD
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-3242
Practice Address - Country:US
Practice Address - Phone:401-722-3313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW018741041C0700X
MA1198721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical