Individual provider Active NPI

David S Stern, LICSW

  • Clinical Social Worker
  • Warwick, RI
National Provider Identifier
1780752006
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW01589 Issued in RI
Practice address
50 Health LN
Warwick, RI 02886-2711
Phone
(401) 738-4300
Fax
(401) 738-8634
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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 ISW01589 RI Primary

Addresses

Primary practice location

50 Health LN
Warwick, RI 02886-2711

Mailing address

50 Health LN
Warwick, RI 02886-2711
Phone (401) 738-4300

Other identifiers 6

IdentifierTypeStateIssuer
31483-7OtherRIBLUE CROSS
1104847946OtherRITHE PROVIDENCE CENTER NPI
1386671535OtherRITHE KENT CENTER
413439OtherRIBLUE CHIP
DS61496MedicaidRI
62-16837OtherRIUNITED BEHAVIORAL HEALTH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW01589RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Center Past Accepting new patients
The Providence Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1780752006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 HEALTH LN",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862711",
            "telephone_number": "401-738-4300",
            "fax_number": "401-738-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 HEALTH LN",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862711",
            "telephone_number": "401-738-4300",
            "fax_number": "401-738-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "DAVID",
        "middle_name": "S",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "31483-7",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE PROVIDENCE CENTER NPI",
            "identifier": "1104847946",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE KENT CENTER",
            "identifier": "1386671535",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "413439",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DS61496",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "62-16837",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.