Provider Demographics
NPI:1306996830
Name:CASCIO, MARYANN ROSE (LICSW)
Entity type:Individual
Prefix:MS
First Name:MARYANN
Middle Name:ROSE
Last Name:CASCIO
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 1:650 ELMGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4920
Mailing Address - Country:US
Mailing Address - Phone:401-529-5683
Mailing Address - Fax:
Practice Address - Street 1:650 ELMGROVE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4920
Practice Address - Country:US
Practice Address - Phone:401-529-5683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
RIISW001381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI809009484Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER