Active NPI
Richard S Dufresne, MSW
- Clinical Social Worker
- Peterborough, NH
National Provider Identifier
1043352644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LICSW #22
- Practice address
- 20 Grove St
Peterborough, NH 03458-1470 - Phone
- (603) 924-7462
- Fax
- (603) 924-2138
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LICSW #22 | NH | Primary |
| Clinical Social Worker | 1041C0700X | LICSW #105557 | MA |
Addresses
Primary practice location
20 Grove St
Peterborough, NH 03458-1470
Mailing address
20 Grove St
Peterborough, NH 03458-1470
Phone (603) 924-7462
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15480 | Other | PATRIOT | |
| 80001847 | Medicaid | NH | |
| NH1631 | Other | HARVARDPILGRIMHEALTHCARE | |
| 69365 | Other | CIGNA | |
| 1400718Y0NH01 | Other | NH | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICSW #105557 | MA | MD | Clinical Social Worker |
| LICSW #22 | NH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043352644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 GROVE ST",
"city": "PETERBOROUGH",
"state": "NH",
"postal_code": "034581470",
"telephone_number": "603-924-7462",
"fax_number": "603-924-2138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 GROVE ST",
"city": "PETERBOROUGH",
"state": "NH",
"postal_code": "034581470",
"telephone_number": "603-924-7462",
"fax_number": "603-924-2138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFRESNE",
"first_name": "RICHARD",
"middle_name": "S",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NH",
"license": "LICSW #22",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "LICSW #105557",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PATRIOT",
"identifier": "15480",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80001847",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARDPILGRIMHEALTHCARE",
"identifier": "NH1631",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "69365",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "1400718Y0NH01",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peterborough, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.