Provider Demographics
NPI:1003293648
Name:MANCINI, BETH (LICSW)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:MANCINI
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 1:151 SINGLETON ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-1832
Mailing Address - Country:US
Mailing Address - Phone:508-373-4074
Mailing Address - Fax:401-235-9064
Practice Address - Street 1:154 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4469
Practice Address - Country:US
Practice Address - Phone:508-373-4074
Practice Address - Fax:401-235-9064
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-04
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW022441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical