Individual provider Active NPI

Carol Jean Leveillee, LCSW

  • Social Worker
  • Fall River, MA
National Provider Identifier
1619452133
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
223827 Issued in MA
Practice address
1082 Davol St
Fall River, MA 02720-1124
Phone
(401) 580-1989
NPI assigned
Oct 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CSW01949 RI
Social Worker 104100000X 223827 MA Primary

Addresses

Primary practice location

1082 Davol St
Fall River, MA 02720-1124

Mailing address

1082 Davol St
Fall River, MA 02720-1124
Phone (401) 580-1989

Other practice location 1

1443 Hartford Ave
Johnston, RI 02919-3224
Phone (401) 273-8100

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
I20190125001982 RI Practitioner - Clinical Social Worker 7719224914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Healthcare IncGroup PAC ID 7719874908, 66 clinicians

Practice addresses (Care Compare)

1443 Hartford Ave
Johnston, RI 02919-3224
Phone (401) 273-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW01949RIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Healthcare Inc CurrentSince Jan 28, 2019 Accepting new patients

Locations

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 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": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1619452133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1082 DAVOL ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201124",
            "telephone_number": "401-580-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1082 DAVOL ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201124",
            "telephone_number": "401-580-1989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1443 Hartford Ave",
            "address_purpose": "LOCATION",
            "city": "Johnston",
            "state": "RI",
            "postal_code": "029193224",
            "country_code": "US",
            "telephone_number": "401-273-8100",
            "fax_number": "401-861-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVEILLEE",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "RI",
            "license": "CSW01949",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "223827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.