Individual provider Active NPI

Joan P Riley, LICSW

  • Clinical Social Worker
  • Fall River, MA
National Provider Identifier
1174793244
Registry record updated Jul 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW01720 Issued in RI
Practice address
700 Shore Dr Unit 605
Fall River, MA 02721
Phone
(401) 924-2046
NPI assigned
Mar 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2018

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 ISW01720 RI Primary

Addresses

Primary practice location

700 Shore Dr Unit 605
Fall River, MA 02721

Mailing address

700 Shore Dr Unit 605
Fall River, MA 02721-1075
Phone (401) 924-2046

Other practice location 1

1516 Atwood Ave
Johnston, RI 02919-3223
Phone (401) 553-1000

Other identifiers 1

IdentifierTypeStateIssuer
GH57134MedicaidRI

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

LicenseStateTypeSpecialty
ISW01720RIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532217600000",
    "number": "1174793244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SHORE DR UNIT 605",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027211075",
            "telephone_number": "401-924-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SHORE DR UNIT 605",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02721",
            "telephone_number": "401-924-2046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1516 Atwood Ave",
            "address_purpose": "LOCATION",
            "city": "Johnston",
            "state": "RI",
            "postal_code": "029193223",
            "country_code": "US",
            "telephone_number": "401-553-1000",
            "fax_number": "401-553-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "JOAN",
        "middle_name": "P",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2018-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GH57134",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.