Individual provider Active NPI

Joanne Louise Doucette, ED.D.

  • Psychologist
  • Providence, RI
National Provider Identifier
1245246222
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS00558 Issued in RI
Practice address
111 Wayland Avenue
Lower Level
Providence, RI 02906-1039
Phone
(401) 871-0501
Fax
(401) 714-0418
NPI assigned
Jul 31, 2006
Last updated
Aug 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PS00558 RI
Psychologist 103T00000X PS00558 RI Primary

Addresses

Primary practice location

111 Wayland Avenue
Lower Level
Providence, RI 02906-1039

Mailing address

111 Wayland Ave Level
Providence, RI 02906-4371
Phone (401) 871-0501

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
I20070411000436 RI Practitioner - Clinical Psychologist 8325143837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Boston University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

154 Waterman St
Suite 11
Providence, RI 02906-3116
Phone (401) 286-1134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS00558RIMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Diversity Counseling LLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

111 Wayland Ave
Providence, RI 02906
Phone (401) 396-7649

111 Wayland Ave
Lowr
Providence, RI 02906
Phone (401) 871-0501

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1245246222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WAYLAND AVE LEVEL",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064371",
            "telephone_number": "401-871-0501",
            "fax_number": "401-714-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WAYLAND AVENUE",
            "address_2": "LOWER LEVEL",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029061039",
            "telephone_number": "401-871-0501",
            "fax_number": "401-714-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUCETTE",
        "first_name": "JOANNE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "RI",
            "license": "PS00558",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PS00558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.