Provider Demographics
NPI:1447543442
Name:DEL VICARIO, ANTHONY JOSEPH III (LCSW)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:DEL VICARIO
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-3439
Mailing Address - Country:US
Mailing Address - Phone:401-451-7727
Mailing Address - Fax:
Practice Address - Street 1:420 FRUIT HILL AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2626
Practice Address - Country:US
Practice Address - Phone:401-353-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI009911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical