IndividualActive
Theodore Blickwedel, MSW, LICSW
NPI 1669957932 · Mental Health Counselor · Johnston, RI
Provider details
- NPI number
- 1669957932
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- MSW, LICSW
- Sex
- Male
- Sole proprietor
- No
- License
- ISW02141 (RI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1395 Atwood Ave Ste 201
Johnston, RI 02919-4931
Phone: (401) 383-7633
Fax: (877) 266-4503
Street-level locationGet directions
Mailing address
1395 Atwood Ave Ste 201
Johnston, RI 02919-4931
Registry dates
- Enumerated
- 2018-10-02
- Last updated
- 2018-10-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.