| Gracious Audette | |
|
7 Rhode Island Ave Newport RI 02840-2606 | |
| (401) 841-9198 | |
| (401) 841-9198 |
| Full Name | Gracious Audette |
|---|---|
| Speciality | Social Worker |
| Location | 7 Rhode Island Ave, Newport, Rhode Island |
| Authorized Official Name and Position | Gracious Ann Audette (SOLE PROPRIETOR) |
| Authorized Official Contact | 4018419198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gracious Audette 7 Rhode Island Ave Newport RI 02840-2606 Ph: (401) 841-9198 | Gracious Audette 7 Rhode Island Ave Newport RI 02840-2606 Ph: (401) 841-9198 |
| NPI Number | 1073855631 |
|---|---|
| Provider Enumeration Date | 03/21/2013 |
| Last Update Date | 03/21/2013 |
| Medicare PECOS PAC ID | 3375789258 |
|---|---|
| Medicare Enrollment ID | O20130419000177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073855631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | ISW02178 (Rhode Island) | Primary |
| Provider Name | Gracious A Audette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184851065 PECOS PAC ID: 6800053562 Enrollment ID: I20120208000070 |
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