MICHAEL PENDERGAST NPI 1043660202

NPI Information

  • NPI: 1043660202
  • Provider Name: MICHAEL PENDERGAST
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 1130 TEN ROD RD
    BUILDING D, SUITE 307-C
    NORTH KINGSTOWN, RI
    ZIP 02852
  • Phone: (401) 301-4526

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NPI Details

MICHAEL PENDERGAST is a clinical social worker in North Kingstown, RI. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MICHAEL PENDERGAST NPI is 1043660202. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1130 TEN ROD RD
BUILDING D, SUITE 307-C
NORTH KINGSTOWN, RI
ZIP 02852-161
Phone: (401) 301-4526

The provider's authorized official is Michael Cole Pendergast .
The authorized official title is Licensed Independent Social Worker and has the following contact phone number (401) 301-4526.

The enumeration date for this NPI number is 6/20/2016 and was last updated on 6/20/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalISW01338RHODE ISLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11124181243OTHERNPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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