Individual provider Active NPI

Jennifer Spivey-Rachlin, LICSW

  • Clinical Social Worker
  • Westerly, RI
National Provider Identifier
1164512554
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1SW1049 Issued in RI
Practice address
85 Beach St
BLDG. B Upper Level
Westerly, RI 02891-2717
Phone
(401) 506-6866
Fax
(401) 596-0493
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1SW1049 RI Primary

Addresses

Primary practice location

85 Beach St
BLDG. B Upper Level
Westerly, RI 02891-2717

Mailing address

85 Beach St
BLDG. B Upper Level
Westerly, RI 02891-2717
Phone (401) 506-6866

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1SW1049RIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164512554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 BEACH ST",
            "address_2": "BLDG. B UPPER LEVEL",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028912717",
            "telephone_number": "401-506-6866",
            "fax_number": "401-596-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BEACH ST",
            "address_2": "BLDG. B UPPER LEVEL",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028912717",
            "telephone_number": "401-506-6866",
            "fax_number": "401-596-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVEY-RACHLIN",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "1SW1049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerly, RI

Sources for this page

Verify at the official NPI Registry.