Active NPI
Kiersten Marek
- Clinical Social Worker
- Johnston, RI
National Provider Identifier
1861510869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW01201
- Practice address
- 1974 Atwood Ave
Johnston, RI 02919-3230 - Phone
- (401) 231-7594
- Fax
- (401) 231-7760
- NPI assigned
- Mar 27, 2007
- 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 | ISW01201 | RI | Primary |
Addresses
Primary practice location
1974 Atwood Ave
Johnston, RI 02919-3230
Mailing address
1974 Atwood Ave
Johnston, RI 02919-3230
Phone (401) 231-7594
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30342 | Other | RI | BLUE CROSS CRISIS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Healthcare Inc | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Pawtucket, RI
- NPI 1821078932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861510869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1974 ATWOOD AVE",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "029193230",
"telephone_number": "401-231-7594",
"fax_number": "401-231-7760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1974 ATWOOD AVE",
"city": "JOHNSTON",
"state": "RI",
"postal_code": "029193230",
"telephone_number": "401-231-7594",
"fax_number": "401-231-7760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAREK",
"first_name": "KIERSTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW01201",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS CRISIS",
"identifier": "30342",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.