Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marlena-Ray Breault, LCDP, ACDP

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1144619172

Marlena-Ray Breault, LCDP, ACDP is a Clinical Social Worker in Providence, Rhode Island. Qualified in 2018, 8 years ago. Practices with Gateway Healthcare Inc, a 64-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
8
Licensed in
RI
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

830 Chalkstone Ave
Providence, RI 02908-4734
Phone: (401) 273-7100
Fax: (401) 525-2586
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1443 Hartford Ave, Johnston, RI 02919-3224 — (401) 273-8100

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence ISW03485 (RI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence CDP00601 (RI)

Record details

NPI number1144619172
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCDP , ACDP
Sole proprietorYes
NPI enumeratedJanuary 14, 2015
Last updated in NPPESAugust 5, 2025
Certification dateAugust 5, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Gateway Healthcare Inc — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Providence