Provider Demographics
NPI:1881924587
Name:PAIVA, MELINDA CARDILLO (MSW, LICSW)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:CARDILLO
Last Name:PAIVA
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 ROOSEVELT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-2134
Mailing Address - Country:US
Mailing Address - Phone:401-724-8400
Mailing Address - Fax:
Practice Address - Street 1:249 ROOSEVELT AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-2134
Practice Address - Country:US
Practice Address - Phone:401-724-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW027571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIISW02757OtherSOCIAL WORKER CLINICAL