Individual provider Active NPI

Deborah A Chick, LICSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1801915285
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW 00488 Issued in RI
Practice address
100 Medway St
Providence, RI 02906-4402
Phone
(401) 421-4100
Fax
(401) 454-5565
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ISW 00488 RI Primary

Addresses

Primary practice location

100 Medway St
Providence, RI 02906-4402

Mailing address

100 Medway St
Providence, RI 02906-4402
Phone (401) 421-4100

Other identifiers 6

IdentifierTypeStateIssuer
3249683OtherRIAETNA
DC 03156MedicaidRI
62-32271OtherRIUNITED HEALTH CARE
1021010OtherRIBEACON
30237-5OtherRIBLUE CROSS BLUE SHIELD
406376OtherRIBLUE CHIP

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
I20120419000339 RI Practitioner - Clinical Social Worker 5395906200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Day OneGroup PAC ID 4880589217, 2 clinicians

Practice addresses (Care Compare)

100 Medway St
Providence, RI 02906-4402
Phone (401) 421-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW 00488RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Day One Clinical CurrentSince Jul 15, 1998 Accepting new patients

Locations

100 Medway St
Providence, RI 02906
Phone (401) 421-4100

Organizations & group practices 1

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801915285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDWAY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064402",
            "telephone_number": "401-421-4100",
            "fax_number": "401-454-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDWAY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064402",
            "telephone_number": "401-421-4100",
            "fax_number": "401-454-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICK",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW 00488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3249683",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC 03156",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "62-32271",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON",
            "identifier": "1021010",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "30237-5",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "406376",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.