NPIMap

Individual provider Active NPI

Melissa Lynn Coe, LICSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1497058283
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02113 Issued in RI
Practice address
610 Manton Ave
3Rd Floor
Providence, RI 02909-5633
Phone
(401) 274-6310
Fax
(401) 421-2152
NPI assigned
Dec 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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 ISW02113 RI Primary

Addresses

Primary practice location

610 Manton Ave
3Rd Floor
Providence, RI 02909-5633

Mailing address

610 Manton Ave
3Rd Floor
Providence, RI 02909-5633
Phone (401) 274-6310

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ISW02113RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Waters Edge Therapy LLC Clinical Past Accepting new patients
The Groden Center Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1497058283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 MANTON AVE",
            "address_2": "3RD FLOOR",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029095633",
            "telephone_number": "401-274-6310",
            "fax_number": "401-421-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 MANTON AVE",
            "address_2": "3RD FLOOR",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029095633",
            "telephone_number": "401-274-6310",
            "fax_number": "401-421-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COE",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-16",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.