James Andrew Brcak, PSY.D.
Individual provider Active NPI Clinical Psychologist · Riverside, RI
NPI 1114089604 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1114089604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PS00969 (RI)
- Practice address
- 1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061 - Phone
- (401) 432-1000
- Fax
- (401) 432-1500
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS00969 | RI | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS00969 | RI | Yes |
Addresses
Primary practice location
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Mailing address
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone (401) 432-1000
Other providers in Riverside, RI
- Donna Lee Brady
- Brainwise LLC
- Christopher T Brannigan
- Russell Bratman
- Braver Medical, PLLC
- Michelle Breda
- Catherine Maclaughlin Brennan
- Deirdre T Brogan
- Brown Medicine
- Brown Medicine
All providers in Riverside, RI · Clinical Psychologist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.