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

Samuel Reilly Dubois, LICSW

Individual provider Clinical Social Worker · NPI 1891437893

Samuel Reilly Dubois, LICSW is a Clinical Social Worker in Providence, Rhode Island. Qualified in 2021, 5 years ago. Licensed in Massachusetts and Rhode Island.

Years since qualifying
5
Licensed in
MA, RI
In the registry since
2022
Specialties on file
3
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

1 Richmond Sq Ste 300E
Providence, RI 02906-5160
Phone: (401) 785-0040
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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 ISW04823 (RI)
Clinical Social Worker Taxonomy 1041C0700X · Licence CSW03213 (RI)
Social Worker Taxonomy 104100000X · Licence 000227826 (MA)

Record details

NPI number1891437893
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedApril 11, 2022
Last updated in NPPESMay 13, 2026
Certification dateMay 13, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Providence