Individual provider Active NPI

Allyson Yvette Ventura-Tesillo, LCSW

  • Clinical Social Worker
  • Pawtucket, RI
National Provider Identifier
1013729581
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW03439 Issued in RI
Practice address
101 Bacon St
Pawtucket, RI 02860-5542
Phone
(401) 722-3560
NPI assigned
Jan 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW03439 RI Primary

Addresses

Primary practice location

101 Bacon St
Pawtucket, RI 02860-5542

Mailing address

101 Bacon St
Pawtucket, RI 02860-5542
Phone (401) 305-0309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW03439RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Healthcare Inc CurrentSince Feb 3, 2025 Accepting new patients

Locations

1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829

101 Bacon St
Pawtucket, RI 02860
Phone (401) 722-3560

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

1 Virginia Ave
Ste 200
Providence, RI 02905

24 Salt Pond Rd
Ste H5
Wakefield, RI 02879
Phone (401) 757-6973

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1013729581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BACON ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605542",
            "telephone_number": "401-305-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BACON ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605542",
            "telephone_number": "401-722-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA-TESILLO",
        "first_name": "ALLYSON",
        "middle_name": "YVETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW03439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.