Individual provider Active NPI

Lawrence Ming-an Chan, PSYD

  • Clinical Psychologist
  • Providence, RI
National Provider Identifier
1033960794
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS02316 Issued in RI
Practice address
1 Richmond SQ Ste 300E
Providence, RI 02906-5160
Phone
(401) 481-8351
NPI assigned
Apr 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X
Clinical Psychologist 103TC0700X PS02316 RI Primary

Addresses

Primary practice location

1 Richmond SQ Ste 300E
Providence, RI 02906-5160

Mailing address

100 Exchange St Unit 607
Providence, RI 02903-2617
Phone (401) 481-8351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250108002404 RI Practitioner - Clinical Psychologist 2466980131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychiatry, Inc.Group PAC ID 5294173464, 90 clinicians

Practice addresses (Care Compare)

1 Richmond SQ
Suite 300E
Providence, RI 02906-5160
Phone (401) 349-3131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychiatry, Inc. CurrentSince Jan 1, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

1 Richmond Sq
Ste 300E
Providence, RI 02906
Phone (401) 481-8351

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1033960794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EXCHANGE ST UNIT 607",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029032617",
            "telephone_number": "401-481-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHMOND SQ STE 300E",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065160",
            "telephone_number": "401-481-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "LAWRENCE",
        "middle_name": "MING-AN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS02316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.