Individual provider Active NPI

Donald Marc Laliberte, L.I.C.S.W.

  • Clinical Social Worker
  • Pawtucket, RI
National Provider Identifier
1174974547
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW01441 Issued in RI
Practice address
249 Roosevelt Ave
Suite 205
Pawtucket, RI 02860-2134
Phone
(401) 724-8400
NPI assigned
Jun 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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 ISW01441 RI Primary

Addresses

Primary practice location

249 Roosevelt Ave
Suite 205
Pawtucket, RI 02860-2134

Mailing address

249 Roosevelt Ave
Suite 205
Pawtucket, RI 02860-2134
Phone (401) 724-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190405000319 RI Practitioner - Clinical Social Worker 5698016350 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince May 3, 2021 Accepting new patients
Emma Pendleton Bradley Hospital Current Accepting new patients
Gateway Healthcare Inc CurrentSince Mar 1, 2019 Accepting new patients
Crossroads Rhode Island Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince May 3, 2021 Accepting new patients
Emma Pendleton Bradley Hospital CurrentSince May 3, 2021 Accepting new patients
Rhode Island Hospital CurrentSince May 3, 2021 Accepting new patients
Lifespan Physician Group, Inc. Clinical CurrentSince May 3, 2021 Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829

249 Roosevelt Ave
Ste 205
Pawtucket, RI 02860
Phone (401) 667-6518

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

1 Virginia Ave
Ste 200
Providence, RI 02905

593 Eddy St
Providence, RI 02903

1011 Veterans Memorial Pkwy
Riverside, RI 02915
Phone (401) 432-1000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1174974547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 ROOSEVELT AVE",
            "address_2": "SUITE 205",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028602134",
            "telephone_number": "401-724-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 ROOSEVELT AVE",
            "address_2": "SUITE 205",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028602134",
            "telephone_number": "401-724-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALIBERTE",
        "first_name": "DONALD",
        "middle_name": "MARC",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.