Mara Reichenberg, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW02760 Issued in RI

Practice address

146 W River St
Providence, RI 02904-2609

Phone

(401) 793-7020

NPI assigned

Sep 30, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• The Providence Center

  • Community/Behavioral Health Agency
  • Providence, RI
  • NPI 1134977598
  NPD (past)

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1134599343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 W RIVER ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 W RIVER ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042609",
            "telephone_number": "401-793-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Hope St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029062532",
            "country_code": "US",
            "telephone_number": "401-228-7257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 Hope St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029062532",
            "country_code": "US",
            "telephone_number": "401-228-7257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REICHENBERG",
        "first_name": "MARA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regional Physician Services Rhode Island PC
• Jameson Rego Rego
• Joshua David Rego, DC
• Stacie Rego, PT
• Rahiya Binte Rehman, M.D.
• Lisa Reichstein, LICSW
• Cerena Reid-Maynard, LCSW
• Emma Margaret Reid, LCSW
• Indira Bela Reid, AGACNP
• Lisa Reidsema, LMHC/MHC/LPC

• Clinical Social Worker in Providence, RI
• Providers in Providence, 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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.