Individual provider Active NPI

Rose Constance Bissonnette, LICSW

  • Clinical Social Worker
  • Warwick, RI
National Provider Identifier
1609997295
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW01221 Issued in RI
Practice address
33 College Hill Rd Ste 30E
Warwick, RI 02886-2767
Phone
(401) 821-6070
Fax
(401) 821-6047
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 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 ISW01221 RI Primary

Addresses

Primary practice location

33 College Hill Rd Ste 30E
Warwick, RI 02886-2767

Mailing address

33 College Hill Rd Ste 30E
Warwick, RI 02886-2767
Phone (401) 821-6070

Other identifiers 4

IdentifierTypeStateIssuer
408623OtherRIBLUE CHIP
30184-6OtherRIBLUE CROSS & BLUE SHIELD
6250114OtherRIUNITED BEHAVIORAL HEALTH
1021900OtherRIBEACON HEALTH STRATEGIES

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
I20140717001166 RI Practitioner - Clinical Social Worker 2961628516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sheehan Psychotherapy Associates, IncGroup PAC ID 2062482599, 11 clinicians

Practice addresses (Care Compare)

33 College Hill Rd
Suite 30E
Warwick, RI 02886-2767
Phone (401) 821-6070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW01221RIMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1609997295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 COLLEGE HILL RD STE 30E",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862767",
            "telephone_number": "401-821-6070",
            "fax_number": "401-821-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 COLLEGE HILL RD STE 30E",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862767",
            "telephone_number": "401-821-6070",
            "fax_number": "401-821-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSONNETTE",
        "first_name": "ROSE",
        "middle_name": "CONSTANCE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "408623",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "30184-6",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "6250114",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "1021900",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.