Active NPI
Edward A Senerchia, PSYD
- Psychologist
- Providence, RI
National Provider Identifier
1184758823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS00683
- Practice address
- 105 Medway Street
Providence, RI 02906 - Phone
- (401) 258-9945
- NPI assigned
- Mar 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS00683 | RI | Primary |
| Psychologist | 103T00000X | 6386 | MA | |
| Psychologist | 103T00000X | 844 | NH |
Addresses
Primary practice location
105 Medway Street
Providence, RI 02906
Mailing address
PO Box 2418
Providence, RI 02906
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 12, 2025 through Jan 12, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6386 | MA | MD | Psychologist |
| PS00683 | RI | MD | Psychologist |
| 844 | NH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184758823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2418",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 MEDWAY STREET",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02906",
"telephone_number": "401-258-9945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SENERCHIA",
"first_name": "EDWARD",
"middle_name": "A",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "RI",
"license": "PS00683",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "6386",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NH",
"license": "844",
"primary": false
}
],
"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 Jul 8, 2007; 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.