Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. David Jon Medeiros, LICSW

Individual provider Mental Health Counselor · NPI 1336204072

Mr. David Jon Medeiros, LICSW is a Mental Health Counselor in Providence, Rhode Island. Practices as a sole proprietor. Licensed in Rhode Island.

Licensed in
RI
In the registry since
2006
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

173 Waterman St
Providence, RI 02906-3919
Phone: (401) 743-1214
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence ISW01114 (RI)

Record details

NPI number1336204072
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedDecember 22, 2006
Last updated in NPPESJuly 8, 2007

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