Active NPI
Raymond J. Chin, PHD, MFA
- Clinical Psychologist
- Hanover, NH
National Provider Identifier
1417060963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 428
- Practice address
- 43 Lebanon St
Hanover, NH 03755-2513 - Phone
- (603) 643-9252
- Fax
- (888) 972-3709
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 428 | NH | Primary |
Addresses
Primary practice location
43 Lebanon St
Hanover, NH 03755-2513
Mailing address
PO Box 176
East Thetford, VT 05043-0176
Phone (603) 643-9252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Fine Arts, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 428 | NH | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer Creek Psychological Associates, PA | Clinical | Past | Accepting new patients |
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": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1417060963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 176",
"city": "EAST THETFORD",
"state": "VT",
"postal_code": "050430176",
"telephone_number": "603-643-9252",
"fax_number": "888-972-3709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 LEBANON ST",
"city": "HANOVER",
"state": "NH",
"postal_code": "037552513",
"telephone_number": "603-643-9252",
"fax_number": "888-972-3709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIN",
"first_name": "RAYMOND",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PHD, MFA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NH",
"license": "428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.