Individual provider Active NPI

Emma Chloe Avruch

  • Clinical Social Worker
  • Warren, RI
National Provider Identifier
1124546650
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW04007 Issued in RI
Practice address
269 Main St
Warren, RI 02885-4305
Phone
(413) 314-3309
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 125146 MA
Clinical Social Worker 1041C0700X ISW04007 RI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

269 Main St
Warren, RI 02885-4305

Mailing address

269 Main St
Warren, RI 02885-4305
Phone (413) 314-3309

Other practice location 1

1600 E Olive St
Seattle, WA 98122-2735
Phone (206) 302-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20220915001198 MA Practitioner - Clinical Social Worker 9133504970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

90 Canal St
Suite 4
Boston, MA 02114-2022
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW04007RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Current Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Feb 15, 2023 Accepting new patients

Locations

90 Canal St
Ste 4
Boston, MA 02114
Phone (617) 517-4889

Interoperability endpoints

  • Direct secure messaging: eavruch@direct.carene.org

Organizations & group practices 2

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": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1124546650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MAIN ST",
            "city": "WARREN",
            "state": "RI",
            "postal_code": "028854305",
            "telephone_number": "413-314-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 MAIN ST",
            "city": "WARREN",
            "state": "RI",
            "postal_code": "028854305",
            "telephone_number": "413-314-3309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 E Olive St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981222735",
            "country_code": "US",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVRUCH",
        "first_name": "EMMA",
        "middle_name": "CHLOE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "125146",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW04007",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, RI

Sources for this page

Verify at the official NPI Registry.