Active NPI
Donna M Cassidy, MSW
- Clinical Social Worker
- Providence, RI
National Provider Identifier
1154484988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW00584
- Practice address
- 189 Governor St
Suite 203
Providence, RI 02906-3124 - Phone
- (401) 273-2447
- Fax
- (401) 274-8070
- NPI assigned
- Dec 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | ISW00584 | RI | Primary |
Addresses
Primary practice location
189 Governor St
Suite 203
Providence, RI 02906-3124
Mailing address
242 Blackstone Blvd
Providence, RI 02906-5813
Phone (401) 273-7112
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3731-4 | Other | RI | BLUE CROSS BLUE SHIELD |
| 18051-361 | Other | RI | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW00584 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154484988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 BLACKSTONE BLVD",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029065813",
"telephone_number": "401-273-7112",
"fax_number": "401-274-8070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "189 GOVERNOR ST",
"address_2": "SUITE 203",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029063124",
"telephone_number": "401-273-2447",
"fax_number": "401-274-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSIDY",
"first_name": "DONNA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW00584",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "3731-4",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "18051-361",
"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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.