Individual provider Active NPI

Anita Minkin, CSW

  • Clinical Social Worker
  • Pawtucket, RI
National Provider Identifier
1063566917
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1SW01289 Issued in RI
Practice address
750 East Ave
Pawtucket, RI 02860-6165
Phone
(401) 457-5252
Fax
(401) 316-0439
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110026 MA
Clinical Social Worker 1041C0700X 1SW01289 RI Primary

Addresses

Primary practice location

750 East Ave
Pawtucket, RI 02860-6165

Mailing address

750 East Ave
Pawtucket, RI 02860-6165
Phone (401) 457-5252

Other identifiers 2

IdentifierTypeStateIssuer
308612OtherRIBLUE CROSS BLUE SHIELD
411510OtherRIBLUE CHIP

Other names 1

  • Anita Berkofsky Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040605000077 RI Practitioner - Clinical Social Worker 6406838622 Practice locations: Pawtucket, RI; Warwick, RI
I20200422001402 OH Practitioner - Clinical Social Worker 6406838622 Practice locations: South Euclid, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

200 Centerville Rd
Warwick, RI 02886-0238
Phone (401) 316-0433

335 Centerville Rd
Warwick, RI 02886-4384
Phone (401) 475-5252

4589 Mayfield Rd
South Euclid, OH 44121-4044
Phone (216) 785-9466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110026MAMDClinical Social Worker
1SW01289RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Christine Richards LLC PastSince Jul 1, 2021 Accepting new patients

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1063566917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 EAST AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028606165",
            "telephone_number": "401-457-5252",
            "fax_number": "401-316-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 EAST AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028606165",
            "telephone_number": "401-457-5252",
            "fax_number": "401-316-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINKIN",
        "first_name": "ANITA",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110026",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "1SW01289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "308612",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "411510",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANITA",
            "last_name": "BERKOFSKY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.