Individual provider Active NPI

Marta Rosol, LICSW

  • Clinical Social Worker
  • Pawtucket, RI
National Provider Identifier
1699010751
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02616 Issued in RI
Practice address
110 Slater Park Ave
Pawtucket, RI 02861-3214
Phone
(401) 316-4425
Fax
(401) 316-4425
NPI assigned
Nov 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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 ISW02616 RI Primary

Addresses

Primary practice location

110 Slater Park Ave
Pawtucket, RI 02861-3214

Mailing address

110 Slater Park Ave
Pawtucket, RI 02861-3214
Phone (401) 316-4425

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
I20160920000142 RI Practitioner - Clinical Social Worker 2668769696 Reassigns benefits to 1 organization
Practice locations: Providence, RI; East Providence, RI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

110 Slater Park Ave
Pawtucket, RI 02861-3214
Phone (401) 316-4425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Clinical Services Inc Clinical CurrentSince Apr 20, 2022 Accepting new patients

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": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1699010751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SLATER PARK AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028613214",
            "telephone_number": "401-316-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SLATER PARK AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028613214",
            "telephone_number": "401-316-4425",
            "fax_number": "401-316-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSOL",
        "first_name": "MARTA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-30",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.