Basic Information
| Provider Information | |||||||||
| NPI: | 1245535160 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARDILLO | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSW,LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 167 WIDOW SWEET RD | ||||||||
| Address2: | |||||||||
| City: | EXETER | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028222714 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1126 HARTFORD AVE | ||||||||
| Address2: | |||||||||
| City: | JOHNSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029197109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4015191943 | ||||||||
| FaxNumber: | 4013516611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2011 | ||||||||
| LastUpdateDate: | 03/21/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | ISWO2208 | RI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.