ANNETTE D SCANLON (LICSW) – Clinical Social Worker, NPI 1396891396

ANNETTE D SCANLON (LICSW) is a healthcare provider. based in Providence, Rhode Island. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. ISW02317 (RI). The NPI Number for ANNETTE D SCANLON (LICSW) is 1396891396

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
ANNETTE D SCANLON (LICSW)
NPI
1396891396
Phone
(401) 331-1350
Address
134 THURBERS AVE
Enumeration Date
25 January 2007
Last Update Date
10 April 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7817424515
Graduation Year
2006 (20 years ago)
PAC ID
6608195078
Group Practice PAC ID
6305187295
Professional Enrollment ID
I20151001000433
Address ID
MA020561850NO65XXXSTXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

712 CLINICAL SOCIAL WORKER in RI

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Provider Addresses for ANNETTE D SCANLON (LICSW)

  • 134, Thurbers Avenue, Providence, Providence County, Rhode Island, 02905, United States

    PROVIDENCE, RI 029054754

    Phone: (401) 331-1350

    Fax: (401) 277-3366

    Type: Mailing

  • 55, Hope Street, Fox Point, Providence, Providence County, Rhode Island, 02903, United States

    PROVIDENCE, RI 029062001

    Phone: (401) 331-1350

    Fax: (401) 277-3366

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-10-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20151001000433IClinical Social WorkerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02905)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305187295View full group profile
NameSpecialtyState
Clinical Social WorkerMA
Clinical Social WorkerMA
Mental Health CounselorMA
-MA
Mental Health CounselorMA
Clinical Social WorkerMA
Mental Health CounselorMA
Clinical Social WorkerMA
Clinical Social WorkerMA
Clinical PsychologistMA

Reviews

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Frequently asked questions

Is ANNETTE D SCANLON (LICSW) listed with a National Provider Identifier?
Yes — ANNETTE D SCANLON (LICSW) has NPI 1396891396 on file in the registry.
Would ANNETTE D SCANLON (LICSW) appear as active to a payer?
You can treat ANNETTE D SCANLON (LICSW) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is ANNETTE D SCANLON (LICSW)?
ANNETTE D SCANLON (LICSW) is associated with Clinical Social Worker in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with ANNETTE D SCANLON (LICSW)?
Directory geography for ANNETTE D SCANLON (LICSW) centers on Providence, Rhode Island.
Does ANNETTE D SCANLON (LICSW) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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