Provider Demographics
NPI:1205479755
Name:CATANZARO, MADISSON A (LCSW)
Entity type:Individual
Prefix:
First Name:MADISSON
Middle Name:A
Last Name:CATANZARO
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 1:400 BALD HILL RD STE 517
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-6100
Mailing Address - Country:US
Mailing Address - Phone:401-732-1500
Mailing Address - Fax:401-738-1085
Practice Address - Street 1:400 BALD HILL RD STE 517
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-6100
Practice Address - Country:US
Practice Address - Phone:401-732-1500
Practice Address - Fax:401-738-1085
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
RICSW026981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)