Anthony M Costagliola, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW02830 Issued in RI

Practice address

1 Richmond SQ Ste 333W
Providence, RI 02906-5156

Phone

(401) 227-0372

NPI assigned

Aug 20, 2019

Last updated

Aug 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gateway Healthcare IncGroup PAC ID 7719874908, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gateway Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pawtucket, RI
  • NPI 1821078932

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Family Service of Rhode Island, Inc.

  • Adult Mental Health Clinic/Center
  • Providence, RI
  • NPI 1598833535

  Single Specialty

  Medicare reassignment NPD
• Thrive Behavioral Health, Inc.

  dba Thrive Behavioral Health

  • Community/Behavioral Health Agency
  • Warwick, RI
  • NPI 1386671535

  Single Specialty

  Medicare reassignment NPD
• Om Therapy

  dba East Coast Mental Wellness

  • Clinical Social Worker
  • Providence, RI
  • NPI 1336591494
  NPD (past)

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1295382737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 HOPE ST APT 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062049",
            "telephone_number": "516-672-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHMOND SQ STE 333W",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065156",
            "telephone_number": "401-227-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTAGLIOLA",
        "first_name": "ANTHONY",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.eastcoastmentalwellness.com",
            "affiliation": "N",
            "endpointDescription": "mental health agency",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Richmond Sq Ste 333W",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029065156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Marie Costa, LCSW
• Stephanie Costa, RN
• Susan E Costa
• Taneia Costa, BT
• Tracy Costa, LMHC
• Doris T Costello, MD
• Elizabeth Costello, OTD, OTR/L
• Ellen M. Costello, PHD
• James Michael Costello, RN
• Kathleen Costello, OT

• 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 Aug 20, 2019; 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.

Verify at the official NPI Registry.