Active NPI
Odessa Holt, MSW
- Clinical Social Worker
- Providence, RI
National Provider Identifier
1811472087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 113568-SW-LICSW
- Practice address
- 1 Hoppin St Ste 304
Providence, RI 02903-4141 - Phone
- (401) 444-3674
- NPI assigned
- Oct 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 113568-SW-LICSW | MA | Primary |
Addresses
Primary practice location
1 Hoppin St Ste 304
Providence, RI 02903-4141
Mailing address
21 Great Cedar Swamp Rd
Rehoboth, MA 02769-2837
Phone (617) 821-3158
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 13, 2023 through Nov 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113568-SW-LICSW | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538524800000",
"number": "1811472087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 GREAT CEDAR SWAMP RD",
"city": "REHOBOTH",
"state": "MA",
"postal_code": "027692837",
"telephone_number": "617-821-3158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HOPPIN ST STE 304",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034141",
"telephone_number": "401-444-3674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "ODESSA",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-03",
"last_updated": "2018-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "113568-SW-LICSW",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.