Individual provider Active NPI

Beverly Poirier, LICSW

  • Clinical Social Worker
  • Portsmouth, RI
National Provider Identifier
1336240563
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW00509 Issued in RI
Practice address
3047 E Main Rd Ste 6
Portsmouth, RI 02871-4262
Phone
(401) 683-7460
Fax
(401) 683-6212
NPI assigned
Sep 26, 2006
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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 ISW00509 RI Primary

Addresses

Primary practice location

3047 E Main Rd Ste 6
Portsmouth, RI 02871-4262

Mailing address

3047 E Main Rd Ste 6
Portsmouth, RI 02871-4262

Other identifiers 1

IdentifierTypeStateIssuer
30710-1OtherRIBCBS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116000401 RI Practitioner - Clinical Social Worker 8921062324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3047 E Main Rd
Suite 6
Portsmouth, RI 02871-4262
Phone (401) 683-7460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW00509RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bpoirier Licsw, Inc Clinical CurrentSince Jan 5, 2015 Accepting new patients

Locations

2444 E Main Rd
Portsmouth, RI 02871
Phone (401) 683-4817

3047 E Main Rd
Ste 6
Portsmouth, RI 02871
Phone (401) 683-7460

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1336240563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3047 E MAIN RD STE 6",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028714262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3047 E MAIN RD STE 6",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028714262",
            "telephone_number": "401-683-7460",
            "fax_number": "401-683-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POIRIER",
        "first_name": "BEVERLY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW00509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30710-1",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, RI

Sources for this page

Verify at the official NPI Registry.