Active NPI
Marie A Fontaine, LICSW
- Clinical Social Worker
- North Kingstown, RI
National Provider Identifier
1861584138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW01350
- Practice address
- 119 Fairfield Dr
North Kingstown, RI 02852-1953 - Phone
- (401) 261-1297
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | ISW01350 | RI | Primary |
Addresses
Primary practice location
119 Fairfield Dr
North Kingstown, RI 02852-1953
Mailing address
119 Fairfield Dr
North Kingstown, RI 02852-1953
Phone (401) 261-1297
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 408283 | Other | RI | BLUE CHIP |
| 25582 | Other | RI | BLUE CROSS |
| 62-28013 | Other | RI | UNITED BEHAVIORAL HEALTH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW01350 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518825600000",
"number": "1861584138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 FAIRFIELD DR",
"city": "NORTH KINGSTOWN",
"state": "RI",
"postal_code": "028521953",
"telephone_number": "401-261-1297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 FAIRFIELD DR",
"city": "NORTH KINGSTOWN",
"state": "RI",
"postal_code": "028521953",
"telephone_number": "401-261-1297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTAINE",
"first_name": "MARIE",
"middle_name": "A",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2018-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW01350",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "408283",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "25582",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "62-28013",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Kingstown, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.