Marissa Bain, LICSW

Individual provider Active NPI Clinical Social Worker · Woonsocket, RI

NPI 1821022393 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1821022393
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
ISW01731 (RI)
Practice address
55 John a Cummings Way
Woonsocket, RI 02895-3247
Phone
(401) 235-7000
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
ISW01731RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Alliance Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW01731 RI Yes

Addresses

Primary practice location

55 John a Cummings Way
Woonsocket, RI 02895-3247

Mailing address

2 Fera St
#107
North Providence, RI 02904-4100
Phone (401) 235-7000

Other identifiers

IdentifierTypeStateIssuer
MB50349MedicaidRI
0000031091OtherRIBLUE CROSS
0000041302OtherRIBLUE CHIP

Other providers in Woonsocket, RI

All providers in Woonsocket, RI · Clinical Social Worker in Rhode Island

Sources for this page

Verify at the official NPI Registry.