Vanessa Allegra Diambou Moulambi, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW04039 Issued in RI

Practice address

103 Bacon St
Pawtucket, RI 02860-5542

Phone

(401) 722-3560

Fax

(401) 722-3593

NPI assigned

Jan 4, 2024

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

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thrive Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Warwick, RI
  • NPI 1386671535

  Community Health Worker

  Medicare reassignment NPD
• Gateway Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pawtucket, RI
  • NPI 1821078932
  NPD

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1942070602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 FLYNN AVE STE 3J",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015420",
            "telephone_number": "802-488-6934",
            "fax_number": "802-488-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BACON ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605542",
            "telephone_number": "401-722-3560",
            "fax_number": "401-722-3593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1138 Pine St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054015353",
            "country_code": "US",
            "telephone_number": "802-488-6000",
            "fax_number": "802-488-6919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAMBOU MOULAMBI",
        "first_name": "VANESSA",
        "middle_name": "ALLEGRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW04039",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "VT",
            "license": "097-0135266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Derossi-Dacosta, RN,CDE,CDOE
• Jeffrey Scott Derouin
• Zeel Pareshkumar Desai, PT
• Joan C Desantis, MD
• Bhupesh Dhananjayan, M.D.
• Kaweh Dias, LCSW
• Leonard Dias
• Joseph A. Diaz, MD
• Alioune Badara Diba
• Michael David Dick, DO

• Clinical Social Worker in Pawtucket, RI
• Providers in Pawtucket, 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 Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.