Provider Demographics
NPI:1396262739
Name:PETRIN LAMBERT, CHRISTIANE (LICSW)
Entity type:Individual
Prefix:
First Name:CHRISTIANE
Middle Name:
Last Name:PETRIN LAMBERT
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 1:54 BRIARWOOD HILL RD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:RI
Mailing Address - Zip Code:02822-5031
Mailing Address - Country:US
Mailing Address - Phone:401-743-6632
Mailing Address - Fax:
Practice Address - Street 1:1 RICHMOND SQ STE 106K
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5136
Practice Address - Country:US
Practice Address - Phone:401-461-5234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-26
Last Update Date:2017-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW027501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical