Individual provider Active NPI

Laura Beth Chalk, PCNS

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Providence, RI
National Provider Identifier
1063687317
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
PPNS00352 Issued in RI
Practice address
208 Governor St FL 2
Providence, RI 02906-3246
Phone
(401) 383-4848
Fax
(401) 383-4811
NPI assigned
Apr 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X PPNS00352 RI Primary

Addresses

Primary practice location

208 Governor St FL 2
Providence, RI 02906-3246

Mailing address

208 Governor St FL 2
Providence, RI 02906-3246
Phone (401) 383-4848

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)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
PPNS00352RIMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1063687317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 GOVERNOR ST FL 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063246",
            "telephone_number": "401-383-4848",
            "fax_number": "401-383-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 GOVERNOR ST FL 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063246",
            "telephone_number": "401-383-4848",
            "fax_number": "401-383-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALK",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "PCNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "RI",
            "license": "PPNS00352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.