Luz Omaira Betancur, CHW

Individual provider Active NPI Community Health Worker · Coventry, RI

NPI 1346032802 · NPPES record last updated May 20, 2025

Key facts

NPI
1346032802
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
License
200350 (RI)
Practice address
375 Tiogue Ave Side Door
Coventry, RI 02816-7114
Phone
(401) 617-8489
NPI assigned
May 20, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
200350RIMDCommunity Health Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 200350 RI Yes

Addresses

Primary practice location

375 Tiogue Ave Side Door
Coventry, RI 02816-7114

Mailing address

1643 Warwick Ave Ste 200
Warwick, RI 02889-1525
Phone (401) 617-8489

Other providers in Coventry, RI

All providers in Coventry, RI · Community Health Worker in Rhode Island

Sources for this page

Verify at the official NPI Registry.