Active NPI
Diane Elaine Reese, LCSW
- Clinical Social Worker
- Charlestown, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW03116
- Practice address
- 4705 Old Post Rd Unit a
Charlestown, RI 02813-1842 - Phone
- (401) 364-7705
- NPI assigned
- Jul 26, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CT | ||
| Clinical Social Worker | 1041C0700X | ISW03116 | RI | Primary |
Addresses
Primary practice location
4705 Old Post Rd Unit a
Charlestown, RI 02813-1842
Mailing address
117 Ellenfiled Street
Suite 101
Providence, RI 02905-4513
Phone (401) 364-7705
Other practice location 1
675 Tower Avenue
Suite 301
Hartford, CT 06112
Phone (860) 714-2750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004235091 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT, RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4705 Old Post Rd
Unit a
Charlestown, RI 02813-1842
Phone (401) 364-7705
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW03116 | RI | MD | Clinical Social Worker |
| 004607 | CT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Healthcare Inc | Current | Accepting new patients | |
| Saint Francis Hospital and Medical Center | Current | Accepting new patients | |
| South Shore Center Inc | Clinical | Current | Accepting new patients |
| Saint Francis Hospital and Medical Center | Current | Accepting new patients |
Locations
114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001
500 Blue Hills Ave
Hartford, CT 06112
Phone (860) 714-2681
1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829
1443 Hartford Ave
Providence, RI 02919
Phone (401) 273-8100
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
1 Virginia Ave
Ste 200
Providence, RI 02905
Organizations & group practices 4
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.
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- NPI 1821078932
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1871713495
-
- Community/Retail Pharmacy
- Hartford, CT
- NPI 1932728698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614729600000",
"number": "1609899855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 ELLENFILED STREET",
"address_2": "SUITE 101",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029054513",
"telephone_number": "401-364-7705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4705 OLD POST RD UNIT A",
"city": "CHARLESTOWN",
"state": "RI",
"postal_code": "028131842",
"telephone_number": "401-364-7705"
}
],
"practiceLocations": [
{
"address_1": "675 Tower Avenue",
"address_2": "Suite 301",
"address_purpose": "LOCATION",
"city": "Hartford",
"state": "CT",
"postal_code": "06112",
"country_code": "US",
"telephone_number": "860-714-2750",
"fax_number": "860-714-8591",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REESE",
"first_name": "DIANE",
"middle_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2021-03-03",
"certification_date": "2021-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW03116",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004235091",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charlestown, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.