Active NPI
Kimberly Bennett
- Clinical Social Worker
- Providence, RI
National Provider Identifier
1740428754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW01954
- Practice address
- 765 Allens Ave
Suite 102
Providence, RI 02905-5443 - Phone
- (401) 490-8900
- Fax
- (401) 490-2619
- NPI assigned
- Jan 29, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW01954 | RI | Primary |
Addresses
Primary practice location
765 Allens Ave
Suite 102
Providence, RI 02905-5443
Mailing address
765 Allens Ave
Suite 102
Providence, RI 02905-5443
Phone (401) 490-8900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW01954 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1740428754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "765 ALLENS AVE",
"address_2": "SUITE 102",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029055443",
"telephone_number": "401-490-8900",
"fax_number": "401-490-2619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "765 ALLENS AVE",
"address_2": "SUITE 102",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029055443",
"telephone_number": "401-490-8900",
"fax_number": "401-490-2619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-29",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW01954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.