Provider Demographics
NPI:1588744221
Name:FILES, E. TRACEY (LICSW)
Entity type:Individual
Prefix:
First Name:E. TRACEY
Middle Name:
Last Name:FILES
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 1:25 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2207
Mailing Address - Country:US
Mailing Address - Phone:401-348-0835
Mailing Address - Fax:401-348-9499
Practice Address - Street 1:25 GRANITE ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2207
Practice Address - Country:US
Practice Address - Phone:401-348-0835
Practice Address - Fax:401-348-9499
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW01004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1041C0700XOtherMEDICAL ASSISTANCE
CT1041C0700XOtherMEDICAL ASSISTANCE
RI24021-7Medicare UPIN
RI6247553Medicare UPIN