Individual provider Active NPI

Estefania Clavijo, LCSW

  • Social Worker
  • Providence, RI
National Provider Identifier
1376150417
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CSW03252 Issued in RI
Practice address
530 N Main St
Providence, RI 02904-5762
Phone
(401) 528-0110
NPI assigned
Sep 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW03252 RI
Social Worker 104100000X CSW03252 RI Primary

Addresses

Primary practice location

530 N Main St
Providence, RI 02904-5762

Mailing address

530 N Main St
Providence, RI 02904-5762
Phone (401) 528-0110

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
I20230901001494 RI Practitioner - Clinical Social Worker 6901269307 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Providence Center IncGroup PAC ID 9739080292, 42 clinicians

Practice addresses (Care Compare)

530 N Main St
Providence, RI 02904-5762
Phone (401) 274-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW03252RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare Sjhsri, LLC Social Worker CurrentSince Jul 29, 2024 Accepting new patients
Prospect Chartercare RWMC, LLC Social Worker CurrentSince Jul 29, 2024 Accepting new patients
Prospect Chartercare Sjhsri, LLC CurrentSince Jul 29, 2024 Accepting new patients
The Providence Center Inc Mental Health CurrentSince Jul 15, 2023 Accepting new patients
Prospect Chartercare RWMC, LLC CurrentSince Jul 29, 2024 Accepting new patients
Community Counseling of Bristol County Inc PastSince Sep 1, 2020 Accepting new patients
The Providence Center Past Accepting new patients

Locations

2 Wake Robin Rd
Lincoln, RI 02865
Phone (401) 333-1747

200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

528 N Main St
Providence, RI 02904
Phone (401) 276-4020

530 N Main St
Providence, RI 02904
Phone (401) 274-2500

171 Service Ave
Warwick, RI 02886
Phone (401) 222-9157

Organizations & group practices 7

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": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1376150417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045762",
            "telephone_number": "401-528-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045762",
            "telephone_number": "401-528-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAVIJO",
        "first_name": "ESTEFANIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW03252",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "RI",
            "license": "CSW03252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.