Provider Demographics
NPI:1962873240
Name:MARTINS ABBOTT, FATIMA (LICSW)
Entity type:Individual
Prefix:MRS
First Name:FATIMA
Middle Name:
Last Name:MARTINS ABBOTT
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 1:101 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-3432
Mailing Address - Country:US
Mailing Address - Phone:401-315-0143
Mailing Address - Fax:401-315-0201
Practice Address - Street 1:101 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-3432
Practice Address - Country:US
Practice Address - Phone:401-315-0143
Practice Address - Fax:401-315-0201
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW012221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical