Amy Mullervy, LISCW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW00340 Issued in RI

Practice address

390 Toll Gate Rd
Ste. K 104
Warwick, RI 02886-4326

Phone

(401) 739-4969

Fax

(401) 739-5158

NPI assigned

May 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• MG Therapy LLC

  • Mental Health Counselor
  • Cranston, RI
  • NPI 1093576530
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356556294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 TOLL GATE RD",
            "address_2": "STE. K 104",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864326",
            "telephone_number": "401-739-4969",
            "fax_number": "401-739-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 TOLL GATE RD",
            "address_2": "STE. K 104",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864326",
            "telephone_number": "401-739-4969",
            "fax_number": "401-739-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLERVY",
        "first_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "LISCW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "LSW00340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AM52558",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "1070770",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3229-8",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ahmad Radwan Mahmoud Muammar, MD
• Muehlberg Medical, LLC
• Shivani Mullahoo, LMHC-A
• Virginia Mullen, RN
• Carol S Muller, FNP-C
• G. Miles Mullervy, LICSW
• Katie Therese Mulligan, R.D.
• Jessica Mullins, CPNP
• Adam Mulvey, BCBA
• Emily Munn, DO

• Clinical Social Worker in Warwick, RI
• Providers in Warwick, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.