Individual provider Active NPI

Michael Alfred Raciti, PHD

  • Clinical Psychologist
  • Lincoln, RI
National Provider Identifier
1033600606
Registry record updated May 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4263-PY-PR Issued in MA
Practice address
12 Wingate Rd
Lincoln, RI 02865-4721
Phone
(401) 722-5256
NPI assigned
May 19, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4263-PY-PR MA Primary

Addresses

Primary practice location

12 Wingate Rd
Lincoln, RI 02865-4721

Mailing address

12 Wingate Rd
Lincoln, RI 02865-4721
Phone (401) 722-5256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4263-PY-PRMAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526688000000",
    "number": "1033600606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WINGATE RD",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654721",
            "telephone_number": "401-722-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WINGATE RD",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654721",
            "telephone_number": "401-722-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACITI",
        "first_name": "MICHAEL",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-19",
        "last_updated": "2018-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "4263-PY-PR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.