Individual provider Active NPI

Kelly Demenezes, MSW

  • Clinical Social Worker
  • Fall River, MA
National Provider Identifier
1619183456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1402 Pleasant St
Fall River, MA 02723-1719
Phone
(508) 679-0962
Fax
(508) 676-5592
NPI assigned
May 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 NU Primary

Addresses

Primary practice location

1402 Pleasant St
Fall River, MA 02723-1719

Mailing address

1402 Pleasant St
Fall River, MA 02723-1719
Phone (508) 679-0962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20260207000690 MA Practitioner - Mental Health Counselor 2163901414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

100 Rosebrook Way
Wareham, MA 02571-1138
Phone (508) 273-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Dec 30, 2025 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Dec 30, 2025 Accepting new patients
Seven Hills Behavioral Health Past Accepting new patients

Locations

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

100 Rosebrook Way
Wareham, MA 02571
Phone (508) 273-4950

Organizations & group practices 3

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619183456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 PLEASANT ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027231719",
            "telephone_number": "508-679-0962",
            "fax_number": "508-676-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 PLEASANT ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027231719",
            "telephone_number": "508-679-0962",
            "fax_number": "508-676-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMENEZES",
        "first_name": "KELLY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.