Kelli Rivelli, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW04259 Issued in RI

Practice address

1126 Hartford Ave
Suite 101
Johnston, RI 02919-7130

Phone

(401) 351-2750

Fax

(401) 351-7002

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in RI

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 1

Specialty

Clinical Social Worker

Education

University of Arkansas College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Child and Family Psychiatry, Inc.Group PAC ID 5294173464, 90 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.kellirivelli@151046.advancedmd-direct.com

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.

• Child and Family Psychiatry, Inc.

  • Psychiatry Physician
  • Warwick, RI
  • NPI 1760863229

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1104919117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 HARTFORD AVE",
            "address_2": "SUITE 101",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029197130",
            "telephone_number": "401-351-2750",
            "fax_number": "401-351-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 HARTFORD AVE",
            "address_2": "SUITE 101",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029197130",
            "telephone_number": "401-351-2750",
            "fax_number": "401-351-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVELLI",
        "first_name": "KELLI",
        "name_prefix": "Miss",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "RI",
            "license": "L.C.D.P. # NOT RCVD",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW04259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TT24187",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhode Island Ear, Nose & Throat Physicians, Inc.
• Rhode Island Periodontics
• Rhode Island Surgeons, Inc.
• Nathan Ribeiro
• Savannah Rose Richard
• Lucrecia Dominga Riz
• Meaghan Robinson, DPT
• Lisa M Rocchio, PHD
• Cheryl Roccio, LCDP
• Thomas Robert Rocco, MD

• Clinical Social Worker in Johnston, RI
• Providers in Johnston, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.