Active NPI
Andrea Jean Hogan, LICSW
- Clinical Social Worker
- Riverside, RI
National Provider Identifier
1144424581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW02134
- Practice address
- 1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061 - Phone
- (401) 432-1000
- Fax
- (401) 432-1500
- NPI assigned
- Jun 11, 2007
- 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 | ISW02134 | RI | Primary |
Addresses
Primary practice location
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Mailing address
593 Eddy St
Potter 3
Providence, RI 02903-4923
Phone (401) 444-4318
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ISW02134 | Other | RI | PROFESSIONAL LICENSE |
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 |
|---|---|---|---|
| ISW02134 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355356800000",
"number": "1144424581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"address_2": "POTTER 3",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034923",
"telephone_number": "401-444-4318",
"fax_number": "401-444-6573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 VETERANS MEMORIAL PKWY",
"city": "RIVERSIDE",
"state": "RI",
"postal_code": "029155061",
"telephone_number": "401-432-1000",
"fax_number": "401-432-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "ANDREA",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-11",
"last_updated": "2012-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW02134",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL LICENSE",
"identifier": "ISW02134",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.