Mr Jeremy Thayer, LICSW | |
426 Scrabbletown Rd, North Kingstown, RI 02852-2001 | |
(401) 829-3355 | |
(401) 667-2733 |
Full Name | Mr Jeremy Thayer |
---|---|
Gender | Male |
Speciality | Social Worker |
Location | 426 Scrabbletown Rd, North Kingstown, Rhode Island |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1518094846 | NPI | - | NPPES |
JT59949 | Medicaid | RI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | ISW01934 (Rhode Island) | Secondary |
104100000X | Social Worker | CSW00983 (Rhode Island) | Primary |
Entity Name | Victa Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104317007 PECOS PAC ID: 0840620894 Enrollment ID: O20200415002461 |
Mailing Address | Practice Location Address |
---|---|
Mr Jeremy Thayer, LICSW 452 Gardiner Rd, West Kingston, RI 02892-1068 Ph: (401) 829-3355 | Mr Jeremy Thayer, LICSW 426 Scrabbletown Rd, North Kingstown, RI 02852-2001 Ph: (401) 829-3355 |
Mrs. Pamela Morelli, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 426 Scrabbletown Rd., North Kingstown, RI 02852 Phone: 401-269-9083 Fax: 401-438-0632 | |
Ms. Martha Dempster, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1130 Ten Rod Rd, D104, North Kingstown, RI 02852 Phone: 401-935-9784 Fax: 401-295-5552 | |
Celine Harper, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1130 Ten Rod Rd Ste C104, North Kingstown, RI 02852 Phone: 401-250-2731 | |
Durinda Chace, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 650 Ten Rod Rd Unit 13, Family Service Of Rhode Island, North Kingstown, RI 02852 Phone: 401-331-1350 Fax: 401-277-3366 | |
Ms. Elizabeth Maria Voso, MSW LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1130 Ten Rod Road, Suite E 205, North Kingstown, RI 02852 Phone: 401-295-8880 Fax: 401-295-8880 | |
Karen M. Connors, ACSW,LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1130 Ten Rod Rd, Suite D104, North Kingstown, RI 02852 Phone: 401-295-5575 Fax: 401-295-5552 | |
Connor Curtis, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 14 King Phillip Cir, North Kingstown, RI 02852 Phone: 774-279-6704 |