Ann Funicello, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW0063 Issued in RI

Practice address

54 Wood Cove Dr
Coventry, RI 02816-6606

Phone

(401) 822-0274

NPI assigned

Nov 2, 2011

Last updated

Nov 2, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1205112422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 WOOD COVE DR",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028166606",
            "telephone_number": "401-822-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 WOOD COVE DR",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028166606",
            "telephone_number": "401-822-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNICELLO",
        "first_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW0063",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "RI",
            "license": "054450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Fedorenko, ACRN
• Donald Reno Ferraro, DDS
• Elsa Ford, FNP-C
• Four Winds Chiropractic, Inc. (Four Winds Chiropractic)
• Joseph Alan Franco Sr., RPH
• Jennifer Gagnon, PHARMD
• Jacqueline Duldulao Ganiron, PT, DPT
• Earl Robert Gauthier, MA
• Dmitry Z Gelfand, DDS
• Genesis

• Clinical Social Worker in Coventry, RI
• Providers in Coventry, 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 Nov 2, 2011; 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.