Active NPI
Colby Diane Brady, LCSW
- Clinical Social Worker
- Johnston, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW02883
- Practice address
- 1443 Hartford Ave
Johnston, RI 02919-3224 - Phone
- (401) 273-8100
- Fax
- (401) 861-8696
- NPI assigned
- Jan 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CSW02883 | RI | |
| Clinical Social Worker | 1041C0700X | CSW02883 | RI | Primary |
Addresses
Primary practice location
1443 Hartford Ave
Johnston, RI 02919-3224
Mailing address
15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260209000907 | RI | Practitioner - Clinical Social Worker | 4284113465 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
15 La Salle SQ
Providence, RI 02903-1814
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW02883 | RI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Healthcare Inc | Current | Accepting new patients |
Locations
1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829
1443 Hartford Ave
Providence, RI 02919
Phone (401) 273-8100
1 Virginia Ave
Ste 200
Providence, RI 02905
15 La Salle Sq
Providence, RI 02903
100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Pawtucket, RI
- NPI 1821078932
RI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771545600000",
"number": "1215641998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 LA SALLE SQ",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029031814",
"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": "1443 HARTFORD AVE",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "029193224",
"telephone_number": "401-273-8100",
"fax_number": "401-861-8696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADY",
"first_name": "COLBY",
"middle_name": "DIANE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-09",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "RI",
"license": "CSW02883",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "CSW02883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Johnston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.