Katie Gangemella, MSW, LCSW

Key facts

NPI

1922582030

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

ISW04131 (RI)

Practice address

1011 Veterans Memorial Pkwy Ste 101
Riverside, RI 02915-5061

Phone

(401) 432-1000

NPI assigned

Sep 25, 2018

Sex

Female

Sole proprietor

No

Organizations & group practices 2

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.

• Emma Pendleton Bradley Hospital Psychiatric Hospital · Riverside, RI · NPI 1578768867
  Medicare reassignment NPD RI
• Emma Pendleton Bradley Hospital Psychiatry Physician · Riverside, RI · NPI 1073705943
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 23, 2024.

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1922582030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY STE 101",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Redfield St Ste 306",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021223653",
            "country_code": "US",
            "telephone_number": "617-288-7450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANGEMELLA",
        "first_name": "KATIE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "223779",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW02851",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW04131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

• Lisa Marie Frappier, DO
• Jillian Marjorie Frasca, FNP-C
• Jessica Fresh, LICSW
• Catherine Ruth Friedman, M.D.
• Tanuja P Gandhi, M.D.
• Nicole Tracy Genest, RN
• Genoa Healthcare LLC
• Gerard G. Gagne, Jr. MD General Adult Psychiatry
• Maddi R Gervasio-Pontarelli, PH.D.
• Cassandra Ann Gibson, MD

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