Provider Demographics
NPI:1689796005
Name:MELANSON-ROSE, FRANCINE ANNE (LICSW)
Entity type:Individual
Prefix:
First Name:FRANCINE
Middle Name:ANNE
Last Name:MELANSON-ROSE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:FRANCINE
Other - Middle Name:ANNE
Other - Last Name:MELANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:615 JEFFERSON BLVD
Mailing Address - Street 2:SUITE 208B
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1357
Mailing Address - Country:US
Mailing Address - Phone:401-737-6436
Mailing Address - Fax:401-732-1228
Practice Address - Street 1:615 JEFFERSON BLVD
Practice Address - Street 2:SUITE 208B
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1357
Practice Address - Country:US
Practice Address - Phone:401-737-6436
Practice Address - Fax:401-732-1228
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW002461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI6262422OtherUNITED BEHAVIORAL HEALTH
RI1021900OtherBEACON HEALTH STRATEGIES
RI411509OtherBLUE CHIP
RI94444-7OtherBLUE CROSS & BLUE SHIELD