Individual provider Active NPI

Andrea G Dougherty, LICSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1568555613
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW01279 Issued in RI
Practice address
1 Richmond SQ Ste 300E
Providence, RI 02906-5160
Phone
(401) 349-3131
NPI assigned
Oct 2, 2006
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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 ISW01279 RI Primary

Addresses

Primary practice location

1 Richmond SQ Ste 300E
Providence, RI 02906-5160

Mailing address

1 Richmond SQ Ste 300E
Providence, RI 02906-5160
Phone (401) 349-3131

Other identifiers 2

IdentifierTypeStateIssuer
412887OtherRIBLUE CHIP
299121OtherRIBLUE CROSS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260209001353 RI Practitioner - Clinical Social Worker 6002395290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Child and Family Psychiatry, Inc.Group PAC ID 5294173464, 90 clinicians

Practice addresses (Care Compare)

1 Richmond SQ
Suite 300E
Providence, RI 02906-5160
Phone (401) 349-3131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW01279RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychiatry, Inc. Clinical CurrentSince Jan 26, 2026 Accepting new patients

Locations

1 Richmond Sq
Ste 300E
Providence, RI 02906
Phone (401) 481-8351

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1568555613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RICHMOND SQ STE 300E",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065160",
            "telephone_number": "401-349-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHMOND SQ STE 300E",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065160",
            "telephone_number": "401-349-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "ANDREA",
        "middle_name": "G",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "412887",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "299121",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.