NPIMap

Organization Active NPI

United Cerebral Palsy of Rhode Island, Inc.

Doing business as New England Wellness Collaborative

  • Community/Behavioral Health Agency
  • Providence, RI
National Provider Identifier
1124585427
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
UNITED CEREBRAL PALSY OF RHODE ISLAND, INC.
Doing business as
New England Wellness Collaborative
Practice address
1 Richmond SQ Ste 103K
Providence, RI 02906-5166
Phone
(508) 812-0613
NPI assigned
Feb 23, 2019
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Julia Bussolari, LICSWNPI 1871174946
Title
Director of Clinical Operations
Phone
(401) 728-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1 Richmond SQ Ste 103K
Providence, RI 02906-5166

Mailing address

200 Main St Ste 210
Pawtucket, RI 02860-4119
Phone (401) 728-1800

Other practice location 1

2843 S County Trl Ste 103&104
East Greenwich, RI 02818-1752
Phone (401) 728-1800

Other practice location 2

200 Main St Ste 210
Pawtucket, RI 02860-4119
Phone (401) 728-1800

Other names 1

  • New England Wellness Collaborative Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220506001118 RI Part B Supplier - Clinic/Group Practice 7214314541 Receives reassigned benefits from 11 practitioners
Practice locations: Pawtucket, RI; East Greenwich, RI; Providence, RI

National Provider Directory

National Provider Directory
Tax ID family
United Cerebral Palsy of Rhode Island7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2843 S County Trl
Ste 103
East Greenwich, RI 02818
Phone (401) 728-1800

2843 S County Trl
Ste 103104
East Greenwich, RI 02818
Phone (401) 728-1800

1130 Ten Rod Rd
Ste 201
North Kingstown, RI 02852
Phone (401) 294-3990

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1550880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1124585427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MAIN ST STE 210",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604119",
            "telephone_number": "401-728-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHMOND SQ STE 103K",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065166",
            "telephone_number": "508-812-0613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2843 S County Trl Ste 103&104",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "028181752",
            "country_code": "US",
            "telephone_number": "401-728-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Main St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Pawtucket",
            "state": "RI",
            "postal_code": "028604119",
            "country_code": "US",
            "telephone_number": "401-728-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UNITED CEREBRAL PALSY OF RHODE ISLAND, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-23",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "BUSSOLARI",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "401-728-1800",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New England Wellness Collaborative",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.