Active NPI
Thomas Mack, LCSW
- Social Worker
- Providence, RI
National Provider Identifier
1508129362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- CSW01571
- Practice address
- 528 N Main St
Providence, RI 02904-5757 - Phone
- (401) 383-5811
- NPI assigned
- Jun 18, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | CSW01571 | RI | Primary |
Addresses
Primary practice location
528 N Main St
Providence, RI 02904-5757
Mailing address
528 N Main St
Providence, RI 02904-5757
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
| License | State | Type | Specialty |
|---|---|---|---|
| CSW01571 | RI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Providence, RI
- NPI 1134977598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395360000000",
"number": "1508129362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "528 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045757",
"telephone_number": "401-383-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "THOMAS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-18",
"last_updated": "2014-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "RI",
"license": "CSW01571",
"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 Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.