Provider Demographics
NPI:1437745213
Name:TSENG-PUTTERMAN, PATCH (LICSW)
Entity type:Individual
Prefix:
First Name:PATCH
Middle Name:
Last Name:TSENG-PUTTERMAN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:SERENA
Other - Middle Name:
Other - Last Name:PUTTERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:74 CONSTITUTION ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-2138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 RICHMOND SQ STE 350W
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5165
Practice Address - Country:US
Practice Address - Phone:401-441-5834
Practice Address - Fax:401-210-8248
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC242151041C0700X
RIISW041621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical