Active NPI
Logan Serabian, LICSW
- Social Worker
- North Providence, RI
National Provider Identifier
1083356604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ISW04132
- Practice address
- 1635 Mineral Spring Ave Ste 206
North Providence, RI 02904-4025 - Phone
- (401) 787-1451
- NPI assigned
- Apr 13, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ISW04132 | RI | Primary |
Addresses
Primary practice location
1635 Mineral Spring Ave Ste 206
North Providence, RI 02904-4025
Mailing address
10 Jackson St
North Providence, RI 02904-4200
Phone (401) 787-1451
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW04132 | RI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762646400000",
"number": "1083356604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 JACKSON ST",
"city": "NORTH PROVIDENCE",
"state": "RI",
"postal_code": "029044200",
"telephone_number": "401-787-1451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 MINERAL SPRING AVE STE 206",
"city": "NORTH PROVIDENCE",
"state": "RI",
"postal_code": "029044025",
"telephone_number": "401-787-1451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERABIAN",
"first_name": "LOGAN",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-13",
"last_updated": "2025-11-09",
"certification_date": "2025-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "RI",
"license": "ISW04132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.