Gisselle Alejandra Baeza, LCSW

Individual provider Active NPI Clinical Social Worker · Riverside, RI

NPI 1366150385 · NPPES record last updated Nov 8, 2022

Key facts

NPI
1366150385
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
CSW03011 (RI)
Practice address
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5099
Phone
(401) 432-1345
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CSW03011RIMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW03011 RI Yes

Addresses

Primary practice location

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5099

Mailing address

47 Concannon St Apt 2
Providence, RI 02904-2127
Phone (401) 432-8852

Other providers in Riverside, RI

All providers in Riverside, RI · Clinical Social Worker in Rhode Island

Sources for this page

Verify at the official NPI Registry.