Doctor Name: | KELLY BARAF |
NPI Number: | 1003061144 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | ISW01936 |
Business Practice Address: | 49 Pavilion Ave Suite 105 Providence, RI - 029051534 |
Business Phone Number: | 4014908900 |
Business Fax Number: | 4014902619 |
Mailing Address: | 4 Lafayette St, PAWTUCKET |
State: | RI |
Postal Code: | 028606122 |
Phone Number: | 4015365339 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2008 |
NPI Last Update Date: | 09/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | ISW01936 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |