Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivy Medeiros, LICSW

Individual provider Clinical Social Worker · NPI 1831610344

Ivy Medeiros, LICSW is a Clinical Social Worker in Woonsocket, Rhode Island. Qualified in 1997, 29 years ago. Works from 2 locations. Licensed in Rhode Island.

Years since qualifying
29
Licensed in
RI
In the registry since
2017
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

245 Main St
Woonsocket, RI 02895-3123
Phone: (401) 235-7000
Fax: (401) 767-4516
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1087 Newman Ave, Seekonk, MA 02771-4426 — (508) 557-1432

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence ISW02077 (RI)

Record details

NPI number1831610344
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJuly 6, 2017
Last updated in NPPESApril 30, 2026
Certification dateApril 30, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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