Carissa Marie Demello, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

221169 Issued in MA

Practice address

575 E Main Rd Unit 2
Middletown, RI 02842-5288

Phone

(401) 271-3414

NPI assigned

Dec 15, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ashby Behavioral Health, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Quincy, MA
  • NPI 1508484304
  NPD (past)

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710547200000",
    "number": "1821532425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 JACQUELINE WAY",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028782783",
            "telephone_number": "401-472-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E MAIN RD UNIT 2",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425288",
            "telephone_number": "401-271-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMELLO",
        "first_name": "CARISSA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2024-03-16",
        "certification_date": "2024-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW01861",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "221169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Dedomenico, OD
• Margaret Degregorio, LICSW
• Marianne F Delguercio, NP
• Paul V Delguercio, MD
• Gail Demarco, RN
• Kara Denahan, LMFT
• Dental Haven LLC
• Donald A. Derolf, MD
• Brian Robert Desimone
• Mary Ellen Di Julio, RN, CDOE

• Clinical Social Worker in Middletown, RI
• Providers in Middletown, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2024; 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.