Provider Demographics
NPI:1306568290
Name:CACERES, ROXANA (LICSW)
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:CACERES
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 1:35 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-3909
Mailing Address - Country:US
Mailing Address - Phone:401-338-9607
Mailing Address - Fax:
Practice Address - Street 1:1035 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3363
Practice Address - Country:US
Practice Address - Phone:401-785-0040
Practice Address - Fax:401-941-7847
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW045371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical