Provider Demographics
NPI:1013083500
Name:CUMMINS-MCLAUGHLIN, STACIE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:
Last Name:CUMMINS-MCLAUGHLIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:STACIE
Other - Middle Name:CUMMINS
Other - Last Name:MCLAUGHLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:2 SURREY RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3636
Mailing Address - Country:US
Mailing Address - Phone:401-247-0116
Mailing Address - Fax:
Practice Address - Street 1:100 LAFAYETTE ST
Practice Address - Street 2:SUITE 305
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6008
Practice Address - Country:US
Practice Address - Phone:401-722-9091
Practice Address - Fax:401-722-5451
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW003771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical