Individual provider Active NPI

Iwona Chelminski, PHD

  • Clinical Psychologist
  • Providence, RI
National Provider Identifier
1457337776
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS00724 Issued in RI
Practice address
146 W River St
Suite 11 B
Providence, RI 02904-2609
Phone
(401) 444-7442
Fax
(401) 444-7109
NPI assigned
Dec 19, 2005
Last updated
Apr 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS00724 RI Primary

Addresses

Primary practice location

146 W River St
Suite 11 B
Providence, RI 02904-2609

Mailing address

593 Eddy St
Potter 3
Providence, RI 02903-4923
Phone (401) 444-4318

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
I20100803000826 RI Practitioner - Clinical Psychologist 1254464845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of North Dakota School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

146 W River St
Suite 11a
Providence, RI 02904-2609
Phone (401) 793-8770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS00724RIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. Clinical CurrentSince Apr 17, 2013 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Apr 17, 2013 Accepting new patients

Locations

950 Warren Ave
Ste 104
East Providence, RI 02914
Phone (401) 606-0606

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

146 W River St
#11A
Providence, RI 02904
Phone (401) 606-8250

146 W River St
Ste 11
Providence, RI 02904
Phone (401) 444-7442

593 Eddy St
Providence, RI 02903

593 Eddy St
#3
Providence, RI 02903
Phone (401) 444-3534

593 Eddy St
#970
Providence, RI 02903
Phone (401) 444-2128

593 Eddy St
Rm 38
Providence, RI 02903
Phone (401) 444-4779

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1457337776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "POTTER 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4318",
            "fax_number": "401-444-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 W RIVER ST",
            "address_2": "SUITE 11 B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042609",
            "telephone_number": "401-444-7442",
            "fax_number": "401-444-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELMINSKI",
        "first_name": "IWONA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS00724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.