Kimberly Pelletier, LCISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW01604 Issued in RI

Practice address

21 College Hill Rd
Warwick, RI 02886-2792

Phone

(401) 615-4247

NPI assigned

Aug 5, 2013

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Service of Rhode Island, Inc.

  • Adult Mental Health Clinic/Center
  • Providence, RI
  • NPI 1598833535
  Medicare reassignment NPD
• Heart & Harmony Holistic Healing

  • Clinical Social Worker
  • Warwick, RI
  • NPI 1972314490
  NPD Authorized official

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1457783193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 FRUIT HILL AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029112626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 COLLEGE HILL RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862792",
            "telephone_number": "401-615-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "KIMBERLY",
        "credential": "LCISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW01604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Dental Care of Rhode Island
• Pediatric Therapy Group of Rhode Island, LLC
• Richard J Pedro, D.O.
• Mayra Ovidia Peguero-Bueno, LMHC
• Grace M Pelletier
• Shaye L. Pelletier, LMHC-A
• Pelvic Health & Wellness LLC
• Ruby Pena Puello, FNP-C
• Rafael David Pena, PTA
• Pendar Investments, Inc.

• 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 Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.