Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Annie Avila, LICSW

Individual provider Clinical Social Worker · NPI 1104760479

Annie Avila, LICSW is a Clinical Social Worker in Providence, Rhode Island. Qualified in 2023, 3 years ago. Licensed in Rhode Island.

Years since qualifying
3
Licensed in
RI
In the registry since
2026
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

40 Candace St
Providence, RI 02908-3747
Phone: (401) 444-0550
Fax: (401) 444-0425
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence ISW04809 (RI)

Record details

NPI number1104760479
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedApril 16, 2026
Last updated in NPPESApril 16, 2026
Certification dateApril 16, 2026
Mailing address375 Allens Ave, Providence, RI 02905-5010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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