Organization Active NPI

Trident Psychological Services

  • Clinical Psychologist
  • East Providence, RI
National Provider Identifier
1306358239
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
TRIDENT PSYCHOLOGICAL SERVICES
Practice address
172 Taunton Ave Ste 208
East Providence, RI 02914-4541
Phone
(401) 450-0729
Fax
(401) 537-1830
NPI assigned
Nov 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Authorized official

Name
Dr. Darren William Holowka, PHDNPI 1104187251
Title
Psychologist/Owner
Phone
(401) 450-0729

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171110000031 RI Part B Supplier - Clinic/Group Practice 4789940537 Receives reassigned benefits from 1 practitioner
Practice locations: East Providence, RI

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1306358239",
    "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": {
        "organization_name": "TRIDENT PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "HOLOWKA",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "401-450-0729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.