Brian Shawn Beaudry

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW01591 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-3428

Fax

(401) 606-2219

NPI assigned

Oct 5, 2023

Last updated

Dec 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1194505180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-3428",
            "fax_number": "401-606-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDRY",
        "first_name": "BRIAN",
        "middle_name": "SHAWN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Beattie, LCDP
• Jacqueline Ann Beatty, MS, RD, LDN
• Courtnie Beaubian, MD
• Francesca L. Beaudoin, M.D.
• Theresa A Beaudreau, LICSW
• Laura Ann Beaudry, LICSW
• Andrea Marie Beaulieu
• Taila Beaulieu, MSW
• Barbara Beauregard, CRNA
• Kristin Beauregard, RNP

• Clinical Social Worker in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.