Provider Demographics
NPI:1427247212
Name:PSYCHOLOGICAL ASSOCIATES OF NEWPORT COUNTY, LLC.
Entity type:Organization
Organization Name:PSYCHOLOGICAL ASSOCIATES OF NEWPORT COUNTY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:401-683-3063
Mailing Address - Street 1:74 WATER ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-4113
Mailing Address - Country:US
Mailing Address - Phone:401-683-3063
Mailing Address - Fax:
Practice Address - Street 1:74 WATER ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4113
Practice Address - Country:US
Practice Address - Phone:401-683-3063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00597103T00000X
RIPS00438103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7859-001OtherBLUE CROSS BLUE SHIELD