Marlena-ray Breault, LCDP,ACDP is a medicare enrolled "Social Worker - Clinical" provider in Providence, Rhode Island. She graduated from healthcare school in 2018 and has 8 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Gateway Healthcare Inc and her current practice location is
830 Chalkstone Ave, Providence, Rhode Island. You can reach out to her office (for appointments etc.) via phone at
(401) 273-7100.
Marlena-ray Breault is licensed to practice in Rhode Island (license number ISW03485) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1144619172.
Healthcare Provider's Profile
| Full Name | Marlena-ray Breault |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 8 Years |
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| Location | 830 Chalkstone Ave, Providence, Rhode Island |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Marlena-ray Breault graduated from medical school in 2018
NPI Data:
- NPI Number: 1144619172
- Provider Enumeration Date: 01/14/2015
- Last Update Date: 08/05/2025
Medicare PECOS Information:
- PECOS PAC ID: 0042664146
- Enrollment ID: I20230922002644
Medical Identifiers
Medical identifiers for Marlena-ray Breault such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1144619172 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CDP00601 (Rhode Island) | Secondary |
| 1041C0700X | Social Worker - Clinical | ISW03485 (Rhode Island) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Gateway Healthcare Inc | 7719874908 | 44 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Marlena-ray Breault allows following entities to bill medicare on her behalf.
| Entity Name | Gateway Healthcare Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1821078932
PECOS PAC ID: 7719874908
Enrollment ID: O20040302001066 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marlena-ray Breault is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Marlena-ray Breault, LCDP,ACDP
117 Ellenfield St Ste 101,
Providence, RI 02905-4541
Ph: (401) 444-6779 | Marlena-ray Breault, LCDP,ACDP
830 Chalkstone Ave,
Providence, RI 02908-4734
Ph: (401) 273-7100 |
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