Providers

CATHERINE STEWART ALLEN, LMFT

NPI 1144387028, individual, Providence, RI, Counselor, Mental Health

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 27 months under one organization, which can be supervisory billing.
  • Records needed.
  • Medicaid dollars per patient on code H0036 ($1632 per patient-month) sit in the top 5% of every provider billing that code.
  • 99% of Medicaid dollars are on codes with a history of abuse.
score 58 of 100, rank 7285, $7.2M at stake

Hours billed per day

Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Jan 2018More hours than a day holds at a conservative unit price14.3200.9133.988.4342190791 H0004 H0036 H2014$333K
Feb 2018More hours than a day holds at a conservative unit price10.1160.7107.146.6303190791 H0004 H0036 H2014$210K
Mar 2018More hours than a day holds at a conservative unit price15.1217.9145.391.8356190791 H0004 H0036 H2014$349K
Apr 2018More hours than a day holds at a conservative unit price15.0219.1146.1101.0353190791 H0004 H0036 H2014$343K
May 2018More hours than a day holds at a conservative unit price14.7221.1147.487.1347190791 H0004 H0036 H2014$351K
Jun 2018More hours than a day holds at a conservative unit price13.2184.4122.984.0299190791 H0004 H0036 H2014$298K
Jul 2018More hours than a day holds at a conservative unit price14.3195.0130.094.9342190791 H0004 H0036 H2014$331K
Aug 2018More hours than a day holds at a conservative unit price16.6221.1147.4114.0357190791 H0004 H0036 H2014$392K
Sep 2018More hours than a day holds at a conservative unit price15.7231.4154.3103.8347190791 H0004 H0036 H2014$364K
Oct 2018More hours than a day holds at a conservative unit price18.4267.2178.1110.6354190791 H0004 H0036 H2014$435K
Nov 2018More hours than a day holds at a conservative unit price12.2174.5116.479.1317190791 H0004 H0036 H2014$283K
Jan 2019More hours than a day holds at a conservative unit price3.753.335.544.01111H0004 H0036 H2014$92K
Feb 2019More hours than a day holds at a conservative unit price5.361.641.049.9123190791 H0004 H2014$112K
Mar 2019More hours than a day holds at a conservative unit price5.464.142.855.3138190791 H0004 H2014$128K
Apr 2019More hours than a day holds at a conservative unit price8.694.362.970.4155190791 H0004 H2014$198K
May 2019More hours than a day holds at a conservative unit price7.190.460.270.51131H0004 H2014$180K
Jun 2019More hours than a day holds at a conservative unit price5.065.443.658.1118190791 H0004 H2014$123K
Jul 2019More hours than a day holds at a conservative unit price4.361.040.748.81021H0004 H2014$117K
Aug 2019More hours than a day holds at a conservative unit price4.256.237.546.1951H0004 H2014$111K
Sep 2019More hours than a day holds at a conservative unit price5.157.238.146.9113190791 H0004 H2014$113K
Oct 2019More hours than a day holds at a conservative unit price5.558.739.145.3127190791 H0004 H2014$120K
Nov 2019More hours than a day holds at a conservative unit price4.251.534.343.51051H0004 H2014$96K
Dec 2019More hours than a day holds at a conservative unit price18.4217.0144.7180.9385190791 H0004 H2014$422K
Jan 2020More hours than a day holds at a conservative unit price28.3328.3218.9242.3412190791 H0004 H2014$580K
Feb 2020More hours than a day holds at a conservative unit price25.6297.8198.5237.0373190791 H0004 H2014$492K
Mar 2020More hours than a day holds at a conservative unit price31.2243.6162.4195.3353190791 H0004 H2014$419K
Apr 2020More hours than a day holds at a conservative unit price30.5154.5103.0122.2358190791 H0004 H2014$258K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameCATHERINE STEWART ALLEN, LMFT
TypeIndividual
StatusActive
NPI issuedJanuary 2, 2007, last updated March 19, 2012
Practice location765 ALLENS AVE, SUITE 102, Providence, RI 02905-5443, 401-490-8918
Mailing address2403 POST RD, Wakefield, RI 02879-7547
Specialties
Counselor, Mental Health (101YM0800X, primary, license MFT00076 RI)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes
codewhat it ispaidshareper patient-monthtypicalrank among providers
H0004Behavioral health counseling and therapy per 15 minhistory of abuse$4.7M58%$1K$174 (top 5% from $559)98th percentile
H2014Skills training and development per 15 minhistory of abuse$2.0M25%$758$298 (top 5% from $3K)78th percentile
H0036Community psychiatric supportive treatment face-to-face per 15 minhistory of abuse$1.2M15%$2K$195 (top 5% from $1K)99th percentile
90791Psychiatric diagnostic evaluation$105K1%$133$105 (top 5% from $228)75th percentile

In this area

15 providers in Providence County, RI carry an indicator in the public record, with $22.4M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by part of a provider network on 6. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1CARE CENTER RHODE ISLAND LLC
East Providence, RI, ranked 100
$270K
  • Listed on the Medicare revocation list since December 1, 2017.
  • Medicaid still paid claims in 67 later months, $270,468 in total.
3BEACON HOSPICE, LLC
East Providence, RI, ranked 989
$1.7M
  • Part of provider network D1-00123, ranked 123 nationally.
3CORTLAND PLACE REHAB CENTER LLC
Greenville, RI, ranked 1385
$75K
  • Part of provider network D1-00083, ranked 83 nationally.
3OVERLOOK EDEN OPERATIONS, LLC
Pascoag, RI, ranked 3154
$0
  • Part of provider network D1-00083, ranked 83 nationally.
3VIOLET SNF HOLDCO LLC
Pawtucket, RI, ranked 4230
$0
  • Part of provider network D1-00091, ranked 91 nationally.
3CL OPERATING LLC
Pascoag, RI, ranked 4389
$0
  • Part of provider network D1-00083, ranked 83 nationally.
3FRIENDLY EDEN OPERATIONS LLC
Woonsocket, RI, ranked 7098
$0
  • Part of provider network D1-00083, ranked 83 nationally.
4PAULO PINA
Providence, RI, ranked 7365
$12.0M
  • Hours beyond a day in 34 months, but with up to 2513 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
All 15 in RI

Recent enforcement in RI

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJIndictedJun 24, 2026
Two Charged in District of Rhode Island as Part of National Fraud Takedown
Two defendants were charged by indictment with using the identity of another person to obtain benefits, including approximately $28,236.42 and $24,018.86 in Rhode Island Medicaid benefits.
DOJOtherFeb 17, 2026
Zynex, Inc. Agrees to Criminal Resolution Addressing Claims of Millions of Dollars of Health Care Fraud, Securities Fraud and Related Offenses
Zynex admitted to submitting excessive and improper claims for medical devices and supplies, including medically unnecessary electrode supplies in excess quantities, to government and private health care payors and patients, and to concealing from investors that its revenues were driven by fraudulent billing.
DOJIndictedJan 21, 2026
Former Zynex, Inc. Executives Charged with Health Care and Securities Fraud and Related Offenses
The indictment alleges that from at least 2017 through late 2025 the former CEO and COO of Zynex, Inc. caused the company to submit fraudulent billings to government and private health care payors and patients for medical devices and supplies that were not medically necessary, not covered, and not agreed to by patients, and used those billings to inflate the company's financial reporting and stock price.
DOJIndictedApr 7, 2025
Pain Management Clinic Owners and Operators Indicted on Health Care Fraud Charges
The owners and operators of a pain management clinic allegedly submitted fraudulent claims to Medicare, Medicare Advantage, Medicaid Managed Care, and four private insurers for purportedly medically necessary services, including acupuncture, physical therapy, and office visits, that were not actually provided to patients, in order to collect payment for massage therapy and other services not provided.
DOJSentencedMar 5, 2025
Addiction Treatment Center Supervisor Sentenced in Scheme to Defraud Federal, State, and Private Health Care Insurers
A clinical social worker supervisor at an addiction treatment center devised and executed a scheme to submit false claims for 45-minute psychotherapy and counseling sessions that lasted only 5-10 minutes or did not occur as billed, defrauding Medicare, Medicaid, and other health insurers of more than $3.5 million.

Referral packet

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