Provider Demographics
NPI:1134250715
Name:CHAUDHRY, MICHELE BAILEY
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:BAILEY
Last Name:CHAUDHRY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OPAL ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3325
Mailing Address - Country:US
Mailing Address - Phone:401-419-0363
Mailing Address - Fax:
Practice Address - Street 1:37 ROLFE SQ FL 2
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-2809
Practice Address - Country:US
Practice Address - Phone:401-419-0363
Practice Address - Fax:401-427-4207
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW012901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical