Provider Demographics
NPI:1427280346
Name:ACCIARI, KRISTEN JEANNE (LICSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:JEANNE
Last Name:ACCIARI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:JEANNE
Other - Last Name:PETRELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:659 SANDY LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-8241
Mailing Address - Country:US
Mailing Address - Phone:401-441-8449
Mailing Address - Fax:888-602-6957
Practice Address - Street 1:659 SANDY LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-8241
Practice Address - Country:US
Practice Address - Phone:401-441-8449
Practice Address - Fax:888-602-6957
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW012591041C0700X
RIISW021841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical