Individual provider Active NPI

Katie Ricciardi, MSW, LCSW

  • Clinical Social Worker
  • Spencer, MA
National Provider Identifier
1538485552
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117360 Issued in MA
Practice address
369 Main St Ste 13
Spencer, MA 01562-1900
Phone
(508) 952-0041
Fax
(508) 952-0041
NPI assigned
Apr 15, 2010
Last updated
Apr 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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 117360 MA Primary

Addresses

Primary practice location

369 Main St Ste 13
Spencer, MA 01562-1900

Mailing address

369 Main St Ste 13
Spencer, MA 01562-1900
Phone (508) 952-0041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20190417000591 MA Practitioner - Clinical Social Worker 6406197698 Reassigns benefits to 1 organization
Practice locations: Spencer, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

369 Main St
Suite 9
Spencer, MA 01562-1900
Phone (508) 952-0041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Connections for Recovery LLC Clinical CurrentSince Jun 11, 2019 Accepting new patients

Locations

369 Main St
Ste 13
Spencer, MA 01562
Phone (508) 952-0041

369 Main St
Ste 9
Spencer, MA 01562
Phone (508) 952-0041

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, 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": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1538485552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 MAIN ST STE 13",
            "city": "SPENCER",
            "state": "MA",
            "postal_code": "015621900",
            "telephone_number": "508-952-0041",
            "fax_number": "508-952-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 MAIN ST STE 13",
            "city": "SPENCER",
            "state": "MA",
            "postal_code": "015621900",
            "telephone_number": "508-952-0041",
            "fax_number": "508-952-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCIARDI",
        "first_name": "KATIE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, MA

Sources for this page

Verify at the official NPI Registry.