Nancy H. Embleton, LICSW

Individual provider Active NPI Clinical Social Worker · South Kingstown, RI

NPI 1629148663 · NPPES record last updated Aug 6, 2024

Key facts

NPI
1629148663
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
ISW01553 (RI)
Practice address
65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569
Phone
(401) 785-0040
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Child and Family Psychiatry, Inc. (90 clinicians)

Practice addresses (Care Compare)

65 Village Square Dr
Suite 302
South Kingstown, RI 02879-2569
Phone (401) 785-0040

Medicare participation

Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050121000019 RI Practitioner - Clinical Social Worker 7618926205 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
ISW01553RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychiatry, Inc. Clinical Current
since Jun 1, 2024
Accepting new patients
Gershon Psychological Associates, LLC Past
since Apr 1, 2013
Accepting new patients
South Shore Center Inc Clinical Past
since Dec 21, 2009
Accepting new patients
Gateway Healthcare Inc Past
since Jul 1, 2013
Accepting new patients

Locations

1485 S County Trl
Unit 107
East Greenwich, RI 02818
Phone (401) 258-1621

65 Village Square Dr
Ste 302
South Kingstown, RI 02879
Phone (844) 754-6564

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

400 Bald Hill Rd
Ste 530
Warwick, RI 02886
Phone (401) 737-9091

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW01553 RI Yes

Addresses

Primary practice location

65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569

Mailing address

65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569
Phone (401) 785-0040

Other practice location 1

400 Bald Hill Rd Ste 530
Warwick, RI 02886-6111
Phone (401) 349-3131

Other practice location 2

1485 S County Trl Unit 107
East Greenwich, RI 02818-1771
Phone (401) 785-0040

Other practice location 3

300 Toll Gate Rd Ste 300
Warwick, RI 02886-4416
Phone (401) 467-0333

Other identifiers

IdentifierTypeStateIssuer
62-26800OtherRIUBH
30625-2OtherRIBLUE CROSS
408778OtherRIBLUE CHIP
NE32088MedicaidRI

Other providers in South Kingstown, RI

All providers in South Kingstown, RI · Clinical Social Worker in Rhode Island

Sources for this page

Verify at the official NPI Registry.