Individual provider Active NPI

Jennifer Gaviria, MSW, LICSW

  • Clinical Social Worker
  • Woonsocket, RI
National Provider Identifier
1801342019
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02928 Issued in RI
Practice address
450 Clinton St
Woonsocket, RI 02895-3207
Phone
(401) 767-4100
Fax
(401) 235-6893
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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 ISW02928 RI Primary

Addresses

Primary practice location

450 Clinton St
Woonsocket, RI 02895-3207

Mailing address

450 Clinton St
Woonsocket, RI 02895-3207
Phone (401) 767-4100

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
I20161019001806 RI Practitioner - Clinical Social Worker 5092003343 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW02928RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thundermist Health Center Current Accepting new patients
Thundermist Health Center CurrentSince Aug 29, 2016 Accepting new patients
Thundermist Health Center CurrentSince Aug 29, 2016 Accepting new patients

Locations

450 Clinton St
Woonsocket, RI 02895

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

Organizations & group practices 3

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1801342019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIRIA",
        "first_name": "JENNIFER",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.