Individual provider Active NPI

Fraynelis Y. Andujar, LICSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1750072740
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW03840 Issued in RI
Practice address
40 Candace St
Providence, RI 02908-3747
Phone
(401) 444-0450
Fax
(401) 444-0425
NPI assigned
May 19, 2023
Last updated
May 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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 ISW03840 RI Primary

Addresses

Primary practice location

40 Candace St
Providence, RI 02908-3747

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 780-2511

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
I20230612002280 RI Practitioner - Clinical Social Worker 5092172775 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Diversity Counseling LLC CurrentSince Jan 24, 2024 Accepting new patients
Dr Joanne L Doucette Psychological Services Inc CurrentSince Jan 24, 2024 Accepting new patients
Collaborative Care Network LLC Clinical CurrentSince Jun 23, 2025 Accepting new patients
Directions for Life Inc CurrentSince Dec 24, 2024 Accepting new patients

Locations

1020 Park Ave
Providence, RI 02910
Phone (401) 396-7649

111 Wayland Ave
Providence, RI 02906
Phone (401) 396-7649

2 Richmond Sq
Ste 204
Providence, RI 02906
Phone (401) 206-0130

Interoperability endpoints

  • Direct secure messaging: andjuar.fraynelis.p1@direct.bvchc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1750072740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-780-2511",
            "fax_number": "401-780-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CANDACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083747",
            "telephone_number": "401-444-0450",
            "fax_number": "401-444-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDUJAR",
        "first_name": "FRAYNELIS",
        "middle_name": "Y.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW03840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.