Jaime Mendez, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW02030 Issued in RI

Practice address

830 Chalkstone Ave
Trailer 36
Providence, RI 02908-4734

Phone

(401) 640-3917

Fax

(401) 525-2557

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• The Providence Center

  • Community/Behavioral Health Agency
  • Providence, RI
  • NPI 1134977598
  NPD (past)
• The Providence Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Providence, RI
  • NPI 1104847946

  Clinical

  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1356558688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ANNETTE AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028614418",
            "telephone_number": "401-640-3917",
            "fax_number": "401-525-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 CHALKSTONE AVE",
            "address_2": "TRAILER 36",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084734",
            "telephone_number": "401-640-3917",
            "fax_number": "401-525-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "JAIME",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JM66771",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Y Men, CCHW
• Marith Men, LICSW
• Ana Roselys Mena, MSW
• Steven Paul Menard, D.O.
• Debbie Mendelsohn, RN
• Jeannette Mendez, LCSW
• Sarina L Mendonca
• Yvonne Mendoza, RN
• Shirley Mengalle Dione, DO
• Erika Ebane Mengalle, DO

• 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 Oct 31, 2016; 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.