Aleah Bagwell-Moreino
Individual provider Active NPI Mental Health Counselor · Pawtucket, RI
NPI 1750520862 · NPPES record last updated Nov 11, 2024
Key facts
- NPI
- 1750520862
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- MHC00921 (RI)
- Practice address
- 101 Bacon St
Pawtucket, RI 02860-5542 - Phone
- (401) 724-8400
- Fax
- (401) 724-8400
- NPI assigned
- Feb 12, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gateway Healthcare Inc
Practice addresses (Care Compare)
1443 Hartford Ave
Johnston, RI 02919-3224
Phone (401) 273-8100
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 |
|---|---|---|---|---|
| I20240130001325 | RI | Practitioner - Mental Health Counselor | 2860845583 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHC00921 | RI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Healthcare Inc | Current |
Accepting new patients |
Locations
1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829
101 Bacon St
Pawtucket, RI 02860
Phone (401) 722-3560
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
1 Virginia Ave
Ste 200
Providence, RI 02905
593 Eddy St
Providence, RI 02903
1443 Hartford Ave
Providence, RI 02919
Phone (401) 273-8100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHC00921 | RI | Yes |
Addresses
Primary practice location
101 Bacon St
Pawtucket, RI 02860-5542
Mailing address
101 Bacon St
Pawtucket, RI 02860-5542
Phone (401) 724-8400
Other providers in Pawtucket, RI
- Ana Aybar
- Kristine M Ayers
- Meaghan Bacon
- Pauline Helene Lauper Bagatelas
- Pamela Marie Bagdasian
- Justin Bailey
- Ratna Bindu Balagani
- M Aurora Balerdi
- Rachel E Ballester
- John Joseph Balletto Jr.
All providers in Pawtucket, RI · Mental Health Counselor 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 Nov 11, 2024. 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.