Active NPI
Jane Borelli-Loomis, LICSW
- Clinical Social Worker
- Providence, RI
National Provider Identifier
1104981448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW00285
- Practice address
- 134 Thurbers Ave
Providence, RI 02905-4754 - Phone
- (401) 331-1350
- Fax
- (401) 277-3366
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW00285 | RI | Primary |
Addresses
Primary practice location
134 Thurbers Ave
Providence, RI 02905-4754
Mailing address
40 Saunders Brook Rd
Chepachet, RI 02814-2003
Phone (401) 331-1350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| JB41884 | Medicaid | RI |
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 |
|---|---|---|---|
| ISW00285 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104981448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 SAUNDERS BROOK RD",
"city": "CHEPACHET",
"state": "RI",
"postal_code": "028142003",
"telephone_number": "401-331-1350",
"fax_number": "401-277-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 THURBERS AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029054754",
"telephone_number": "401-331-1350",
"fax_number": "401-277-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORELLI-LOOMIS",
"first_name": "JANE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW00285",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "JB41884",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
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.