Active NPI
Mary Ann Bettencourt, LCSW
- Social Worker
- Blackstone, MA
National Provider Identifier
1588944797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 218886
- Practice address
- 8 Butler Street
Blackstone, MA 01504 - Phone
- (508) 883-5810
- Fax
- (508) 883-5819
- NPI assigned
- Aug 18, 2011
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | CSW01438 | RI | |
| Social Worker | 104100000X | 218886 | MA | Primary |
Addresses
Primary practice location
8 Butler Street
Blackstone, MA 01504
Mailing address
8 Butler Street
Blackstone, MA 01504
Phone (508) 883-5818
Other practice location 1
153 Summer St
Providence, RI 02903-4011
Phone (401) 276-4382
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 |
|---|---|---|---|
| 218886 | MA | MD | Social Worker |
| CSW01438 | RI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 8 Butler St., Inc. | Past | Accepting new patients | |
| Carl M Sousa PC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Blackstone Nursing Home
- Skilled Nursing Facility
- Blackstone, MA
- NPI 1164583589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1588944797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 BUTLER STREET",
"city": "BLACKSTONE",
"state": "MA",
"postal_code": "01504",
"telephone_number": "508-883-5818",
"fax_number": "508-883-5819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 BUTLER STREET",
"city": "BLACKSTONE",
"state": "MA",
"postal_code": "01504",
"telephone_number": "508-883-5810",
"fax_number": "508-883-5819"
}
],
"practiceLocations": [
{
"address_1": "153 Summer St",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029034011",
"country_code": "US",
"telephone_number": "401-276-4382",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BETTENCOURT",
"first_name": "MARY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-18",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "RI",
"license": "CSW01438",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "218886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blackstone, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.