Active NPI
Norman Fortin, LICSW
- Social Worker
- Providence, RI
National Provider Identifier
1588061584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ISW00263
- Practice address
- 49 Pavilion Ave
Ste 105
Providence, RI 02905-1534 - Phone
- (401) 490-8963
- NPI assigned
- Nov 20, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | ISW00263 | RI | Primary |
Addresses
Primary practice location
49 Pavilion Ave
Ste 105
Providence, RI 02905-1534
Mailing address
610 Tower Hill Rd
North Kingstown, RI 02852-5627
Phone (401) 294-4473
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
| License | State | Type | Specialty |
|---|---|---|---|
| ISW00263 | RI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416528000000",
"number": "1588061584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 TOWER HILL RD",
"city": "NORTH KINGSTOWN",
"state": "RI",
"postal_code": "028525627",
"telephone_number": "401-294-4473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 PAVILION AVE",
"address_2": "STE 105",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029051534",
"telephone_number": "401-490-8963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTIN",
"first_name": "NORMAN",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-20",
"last_updated": "2014-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "RI",
"license": "ISW00263",
"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 Nov 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.