MARLENA-RAY BREAULT LCDP,ACDP
NPI 1144619172
Social Worker - Clinical in Providence, RI

Q: What is Marlena-ray Breault's NPI number?

The NPI number for Marlena-ray Breault is 1144619172. It was assigned to this individual provider in the NPPES registry on January 14, 2015.

Q: What is Marlena-ray Breault's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since January 14, 2015PECOS EnrolledAccepts Medicare Assignment

830 CHALKSTONE AVE, PROVIDENCE, RI 02908(401) 273-7100(401) 525-2586 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 5, 2025, Sep 6, 2023 (2 updates tracked since 2023).

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About Marlena-ray Breault Lcdp,acdp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARLENA-RAY BREAULT LCDP,ACDP (NPI 1144619172) is an individual clinical provider in Providence, Rhode Island, licensed in Rhode Island (ISW03485) and active in the NPI registry since January 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Johnston, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1144619172

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMARLENA-RAY BREAULTCredential: LCDP,ACDP

Location Address830 CHALKSTONE AVEProvidence, RI 02908-4734

Mailing Address117 Ellenfield St Ste 101Providence, RI 02905-4541 · (401) 444-6779

Phone(401) 273-7100

Fax(401) 525-2586

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateJanuary 14, 2015

Last NPPES UpdateAugust 5, 20252 updates tracked since enumeration

NPPES CertifiedAugust 5, 2025

✔ NPI 1144619172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in RI · ISW03485

Definition

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.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License CDP00601 (RI)

830 CHALKSTONE AVE, Providence, RI 02908

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Secondary Practice Location 1

Location 11443 Hartford AveJohnston, RI 02919-3224 · Phone (401) 273-8100

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marlena-ray Breault Lcdp,acdp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42664146

PECOS Enrollment IDI20230922002644

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Marlena-ray Breault reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gateway Healthcare Inc

4.3 mi

Mental Health (Including Community Mental Health Center)

101-103 BACON ST
Pawtucket, RI 02860

Reassigned Medicare billing, Rhode Island enrollment
150 clinicians in this Medicare group

NPI 1821078932 (401) 722-3560

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02908 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $58.57 – $177.03

Typical copayment $0.00 (range $14.64 – $44.25)

Most-billed visit code NA

Established Patient

$72.93 typical visit price

range $18.92 – $144.38

Typical copayment $18.23 (range $4.73 – $36.09)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH SEVIN

Social Worker (Clinical)