Individual provider Active NPI

Wesley Cruz, LICSW

  • Clinical Social Worker
  • Woonsocket, RI
National Provider Identifier
1184341588
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ICSW03647 Issued in RI
Practice address
800 Clinton St
Woonsocket, RI 02895-3245
Phone
(401) 235-7000
Fax
(401) 767-4516
NPI assigned
Oct 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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 ICSW03647 RI Primary

Addresses

Primary practice location

800 Clinton St
Woonsocket, RI 02895-3245

Mailing address

PO Box 1700
Woonsocket, RI 02895-0856
Phone (401) 235-7000

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
I20241231003319 RI Practitioner - Clinical Social Worker 8820525900 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ICSW03647RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blackstone Valley Community Health Care, Inc. CurrentSince Oct 20, 2024 Accepting new patients
Blackstone Valley Community Health Care, Inc. Past Accepting new patients

Locations

1000 Broad St
Central Falls, RI 02863
Phone (401) 722-0081

9 Chestnut St
Central Falls, RI 02863
Phone (401) 722-0081

39 East Ave
Pawtucket, RI 02860
Phone (401) 722-0081

Interoperability endpoints

  • Direct secure messaging: wesley.cruz.p1@direct.bvchc.nextgenshare.com

Organizations & group practices 2

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": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1184341588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1700",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950856",
            "telephone_number": "401-235-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953245",
            "telephone_number": "401-235-7000",
            "fax_number": "401-767-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "WESLEY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ICSW03647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.