Provider Demographics
NPI:1194935072
Name:PATERSON, MURIEL BERTHA (LICSW)
Entity type:Individual
Prefix:MRS
First Name:MURIEL
Middle Name:BERTHA
Last Name:PATERSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MISS
Other - First Name:MURIEL
Other - Middle Name:BERTHA
Other - Last Name:GLODE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:30 GROVE LN
Mailing Address - Street 2:
Mailing Address - City:PASCOAG
Mailing Address - State:RI
Mailing Address - Zip Code:02859-3012
Mailing Address - Country:US
Mailing Address - Phone:401-567-0881
Mailing Address - Fax:
Practice Address - Street 1:30 GROVE LN
Practice Address - Street 2:
Practice Address - City:PASCOAG
Practice Address - State:RI
Practice Address - Zip Code:02859-3012
Practice Address - Country:US
Practice Address - Phone:401-567-0881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW018551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical