Provider Demographics
NPI:1841503828
Name:GAETANO, CHAD S (BSW)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:S
Last Name:GAETANO
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
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Mailing Address - Street 1:72 GOUGH AVE
Mailing Address - Street 2:APT 67
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-4628
Mailing Address - Country:US
Mailing Address - Phone:401-615-9306
Mailing Address - Fax:
Practice Address - Street 1:1625 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-1541
Practice Address - Country:US
Practice Address - Phone:401-762-1511
Practice Address - Fax:401-762-1609
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)