Individual provider Active NPI

Kerri L Mowbray, LICSW

  • Clinical Social Worker
  • Warwick, RI
National Provider Identifier
1366734089
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02142 Issued in RI
Practice address
30 Bunting Rd
Warwick, RI 02889-3706
Phone
(401) 527-3102
NPI assigned
May 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2011

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 ISW02142 RI Primary

Addresses

Primary practice location

30 Bunting Rd
Warwick, RI 02889-3706

Mailing address

30 Bunting Rd
Warwick, RI 02889-3706
Phone (401) 921-1679

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
I20130416000436 RI Practitioner - Clinical Social Worker 8527204635 Reassigns benefits to 1 organization
Practice locations: Providence, RI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW02142RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner You of Massachusetts Clinical Current Accepting new patients
The Inner You Clinical CurrentSince Jan 1, 2015 Accepting new patients

Locations

1023 Post Rd
Warwick, RI 02888
Phone (401) 773-7116

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1366734089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BUNTING RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028893706",
            "telephone_number": "401-921-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BUNTING RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028893706",
            "telephone_number": "401-527-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWBRAY",
        "first_name": "KERRI",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.