Active NPI
Patricia Wong, PHD
- Clinical Psychologist
- East Providence, RI
National Provider Identifier
1043931686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS02113
- Practice address
- 400 Massasoit Ave
East Providence, RI 02914-2012 - Phone
- (401) 294-0451
- NPI assigned
- Sep 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS02113 | RI | Primary |
Addresses
Primary practice location
400 Massasoit Ave
East Providence, RI 02914-2012
Mailing address
400 Massasoit Ave
East Providence, RI 02914-2012
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 1, 2025 through Sep 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS02113 | RI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1043931686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 MASSASOIT AVE",
"city": "EAST PROVIDENCE",
"state": "RI",
"postal_code": "029142012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 MASSASOIT AVE",
"city": "EAST PROVIDENCE",
"state": "RI",
"postal_code": "029142012",
"telephone_number": "401-294-0451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "PATRICIA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-12",
"last_updated": "2022-09-12",
"certification_date": "2022-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS02113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.