Individual provider Active NPI

Darren William Holowka, PH.D.

  • Clinical Psychologist
  • East Providence, RI
National Provider Identifier
1104187251
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01423 Issued in RI
Practice address
172 Taunton Ave Ste 208
East Providence, RI 02914-4541
Phone
(401) 450-0729
Fax
(401) 537-1830
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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 PS01423 RI Primary

Addresses

Primary practice location

172 Taunton Ave Ste 208
East Providence, RI 02914-4541

Mailing address

172 Taunton Ave Ste 208
East Providence, RI 02914-4541
Phone (401) 450-0729

Other identifiers 2

IdentifierTypeStateIssuer
9490OtherMAPROFESSIONAL LICENSE
PS01423OtherRIPROFESSIONAL LICENSE

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
I20140402001494 RI Practitioner - Clinical Psychologist 0749428662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

172 Taunton Ave
Suite 208
East Providence, RI 02914-4541
Phone (401) 450-0729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS01423RIMDClinical Psychologist

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1104187251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 TAUNTON AVE STE 208",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029144541",
            "telephone_number": "401-450-0729",
            "fax_number": "401-537-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 TAUNTON AVE STE 208",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029144541",
            "telephone_number": "401-450-0729",
            "fax_number": "401-537-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLOWKA",
        "first_name": "DARREN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "9490",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "PS01423",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.