Individual provider Active NPI

Joseph Carr, LICSW

  • Clinical Social Worker
  • Wakefield, RI
National Provider Identifier
1447312467
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW01635 Issued in RI
Practice address
1157 South Rd
Wakefield, RI 02879-7633
Phone
(401) 364-7705
Fax
(401) 783-2558
NPI assigned
Dec 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ISW01635 RI Primary

Addresses

Primary practice location

1157 South Rd
Wakefield, RI 02879-7633

Mailing address

1157 South Rd
Wakefield, RI 02879-7633
Phone (401) 364-7705

Other identifiers 1

IdentifierTypeStateIssuer
JC55484MedicaidRI

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW01635RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Center Inc Clinical PastSince Dec 21, 2009 Accepting new patients
Gateway Healthcare Inc PastSince Jul 1, 2013 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447312467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 SOUTH RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028797633",
            "telephone_number": "401-364-7705",
            "fax_number": "401-783-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 SOUTH RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028797633",
            "telephone_number": "401-364-7705",
            "fax_number": "401-783-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "JOSEPH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JC55484",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

  • 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.