Provider Demographics
NPI:1306912837
Name:MCNEIECE, MICHELE B (MSW LICSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:B
Last Name:MCNEIECE
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 1:10 CALEF AVE
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882
Mailing Address - Country:US
Mailing Address - Phone:401-792-1185
Mailing Address - Fax:
Practice Address - Street 1:23 NORTH RD
Practice Address - Street 2:
Practice Address - City:PEACE DALE
Practice Address - State:RI
Practice Address - Zip Code:02883
Practice Address - Country:US
Practice Address - Phone:401-212-6181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW01396104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI257783OtherBLUE CROSS
410701OtherBLUE CHIP