Active NPI
Melissa Carbone, LCDP
- Mental Health Counselor
- Pawtucket, RI
National Provider Identifier
1720353071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHC0067-A
- Practice address
- 101 Bacon St
Pawtucket, RI 02860-5542 - Phone
- (401) 722-3560
- Fax
- (401) 722-4120
- NPI assigned
- Mar 20, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDP00569 | RI | |
| Mental Health Counselor | 101YM0800X | CDP00569 | RI | |
| Mental Health Counselor | 101YM0800X | MHC0067-A | RI | Primary |
Addresses
Primary practice location
101 Bacon St
Pawtucket, RI 02860-5542
Mailing address
101 Bacon St
Pawtucket, RI 02860-5542
Phone (401) 722-3560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GH57134 | Medicaid | RI |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
200 Corliss St
Suite 1
Providence, RI 02904-2602
Phone (401) 606-8530
Hospital & facility affiliations
- Rhode Island Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDP00569 | RI | MD | Mental Health Counselor |
| MHC0067-A | RI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhode Island Hospital | Current | Accepting new patients | |
| Rhode Island Hospital | Addiction (Substance Use Disorder) | Current | Accepting new patients |
Locations
200 Corliss St
#1
Providence, RI 02904
Phone (401) 606-8530
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Providence, RI
- NPI 1154537520
Addiction (Substance Use Disorder), RI
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706486400000",
"number": "1720353071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BACON ST",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028605542",
"telephone_number": "401-722-3560",
"fax_number": "401-722-4120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BACON ST",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028605542",
"telephone_number": "401-722-3560",
"fax_number": "401-722-4120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARBONE",
"first_name": "MELISSA",
"credential": "LCDP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-20",
"last_updated": "2024-01-29",
"certification_date": "2024-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "RI",
"license": "CDP00569",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "RI",
"license": "CDP00569",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "RI",
"license": "MHC0067-A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GH57134",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.