Individual provider Active NPI

Ronald G Pelletier, LICSW

  • Clinical Social Worker
  • New Bedford, MA
National Provider Identifier
1225106479
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1024879 Issued in MA
Practice address
106 Spring St
#112
New Bedford, MA 02740-5951
Phone
(508) 993-3100
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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 1024879 MA Primary

Addresses

Primary practice location

106 Spring St
#112
New Bedford, MA 02740-5951

Mailing address

106 Spring St
#112
New Bedford, MA 02740-5951
Phone (508) 993-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050804000563 MA Practitioner - Clinical Social Worker 8224067863 Practice locations: New Bedford, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

401 County St
New Bedford, MA 02740-4935
Phone (508) 993-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1024879MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1225106479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SPRING ST",
            "address_2": "#112",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027405951",
            "telephone_number": "508-993-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SPRING ST",
            "address_2": "#112",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027405951",
            "telephone_number": "508-993-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "RONALD",
        "middle_name": "G",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1024879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.