Leah Anne Berg, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW01987 Issued in RI

Practice address

160 Beechwood Ave
Pawtucket, RI 02860-3414

Phone

(401) 724-8400

Fax

(401) 722-5280

NPI assigned

Mar 3, 2006

Last updated

Mar 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Leah Anne Sullivan Other name

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gateway Healthcare IncGroup PAC ID 7719874908, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gateway Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pawtucket, RI
  • NPI 1821078932
  Medicare reassignment Care Compare group NPD
• Affinity Physicians LLC.

  • Internal Medicine Physician
  • Warwick, RI
  • NPI 1184944662
  Medicare reassignment NPD
• Affinity Physicians LLC

  • Anesthesiology Physician
  • Providence, RI
  • NPI 1053038471
  NPD
• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1285059287

  Clinical

  NPD
• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • Cardiovascular Disease Physician
  • Providence, RI
  • NPI 1326463548
  NPD
• Gateway Healthcare, Inc

  • Clinical Social Worker
  • Pawtucket, RI
  • NPI 1154351211
  NPD (past)
• The Providence Center

  • Community/Behavioral Health Agency
  • Providence, RI
  • NPI 1134977598
  NPD (past)

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1992772438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BEECHWOOD AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028603414",
            "telephone_number": "401-724-8400",
            "fax_number": "401-722-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BEECHWOOD AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028603414",
            "telephone_number": "401-724-8400",
            "fax_number": "401-722-5280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Toll Gate Rd",
            "address_2": "Kent Emergency Dept",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERG",
        "first_name": "LEAH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GH57134",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "SULLIVAN",
            "middle_name": "ANNE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Susan Benesch, MASTERS
• Michael Benevides, LMHC, LCDP
• Janet M Benson, NP
• Antonio Bento, BACHELORS
• Krystal L. Bento
• Brandon Scott Bergman
• Maria A Bermudez, PHYSICIAN ASST PAC
• Amir Bernaba, MD
• Meghan Bernier, LICSW
• Jackie Berry, CSSA

• 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 Mar 18, 2024; 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.