Individual provider · Type 1 NPI

Leon O. Back Iv, LICSW

Clinical Social Worker · Providence, RI

NPI number 1720558745 Active

Practice location

78 Baker St
Providence, RI 02905-4417

Call (401) 781-2400 Map

Fax (401) 781-2687

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XISW03876 (RI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1720558745

Leon O. Back Iv, LICSW's National Provider Identifier is 1720558745, issued on Dec 3, 2018. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Providence, RI. The record was last updated on Apr 4, 2024.