Elizabeth Bogardus Ison, LICSW SOCIAL WORKER
Individual provider Active NPI Social Worker · Wakefield, RI
NPI 1730196403 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1730196403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- ISW01309 (RI)
- Practice address
- 24 Salt Pond Road
Ste D4
Wakefield, RI 02879 - Phone
- (401) 789-3694
- Fax
- (401) 789-3748
- NPI assigned
- Aug 2, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Delta Consultants of South County Inc
Practice addresses (Care Compare)
24 Salt Pond Rd
D4
Wakefield, RI 02879-4334
Phone (401) 789-3694
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190405000578 | RI | Practitioner - Clinical Social Worker | 3375884034 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delta Consultants of South County Inc | Social Worker | Current |
Accepting new patients |
| Communities for People, Inc | Past | Accepting new patients | |
| Align Physical Therapy | Past |
Accepting new patients |
Locations
24 Salt Pond Rd
Ste D4
Wakefield, RI 02879
Phone (401) 667-4965
24 Salt Pond Rd
Ste H1
Wakefield, RI 02879
Phone (401) 789-2424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ISW01309 | RI | Yes |
Addresses
Primary practice location
24 Salt Pond Road
Ste D4
Wakefield, RI 02879
Mailing address
165 North Road
South Kingstown, RI 02879
Phone (401) 782-2896
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 263186 | Other | RI | RI BLUE CROSS |
| EI41628 | Medicaid | RI |
Other providers in Wakefield, RI
- Joseph G Hyde
- Jill Susan Iacono
- Michael Raymond Iannuccilli
- Savannah Iasimone
- Innovative Works
- Sherry Jackson
- Susan Charlotte Jacobsen
- James F. Griffin
- Elise N Jarvis
- Jee Q. Liang, M.D
All providers in Wakefield, RI · Social Worker in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.