Active NPI
Mary Katherine Dixon-Standard, MSW, LICSW
- Clinical Social Worker
- Warwick, RI
National Provider Identifier
1912100710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW01464
- Practice address
- 2020 Elmwood Ave
Warwick, RI 02888-2404 - Phone
- (401) 781-2700
- NPI assigned
- Jun 8, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ISW01404 | RI | |
| Mental Health Counselor | 101YM0800X | ISW01464 | RI | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ISW01464 | RI | |
| Clinical Social Worker | 1041C0700X | ISW01464 | RI | Primary |
Addresses
Primary practice location
2020 Elmwood Ave
Warwick, RI 02888-2404
Mailing address
2020 Elmwood Ave
Warwick, RI 02888
Phone (401) 781-2700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4201380 | Medicaid | RI |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW01404 | RI | MD | Addiction (Substance Use Disorder) Counselor |
| ISW01464 | RI | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgemark, 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.
-
- Substance Abuse Rehabilitation Facility
- Warwick, RI
- NPI 1801966510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385424000000",
"number": "1912100710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 ELMWOOD AVE",
"city": "WARWICK",
"state": "RI",
"postal_code": "02888",
"telephone_number": "401-781-2700",
"fax_number": "401-781-2790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 ELMWOOD AVE",
"city": "WARWICK",
"state": "RI",
"postal_code": "028882404",
"telephone_number": "401-781-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIXON-STANDARD",
"first_name": "MARY",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-08",
"last_updated": "2013-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "RI",
"license": "ISW01404",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "RI",
"license": "ISW01464",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "RI",
"license": "ISW01464",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW01464",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4201380",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.