Individual provider Active NPI

Christina Mei-Chia Fucci, PSY.D

  • Clinical Psychologist
  • Warwick, RI
National Provider Identifier
1487987863
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01147 Issued in RI
Practice address
400 Bald Hill Road
Suite 530
Warwick, RI 02886
Phone
(401) 349-3131
Fax
(401) 921-5109
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 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 PS01147 RI Primary

Addresses

Primary practice location

400 Bald Hill Road
Suite 530
Warwick, RI 02886

Mailing address

400 Bald Hill Road
Suite 530
Warwick, RI 02886
Phone (401) 349-3131

Other identifiers 1

IdentifierTypeStateIssuer
11999213OtherRICAQH PROVIDER ID

Other names 1

  • Christina Fucci Former name

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
I20140429000971 RI Practitioner - Clinical Psychologist 3375776321 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS01147RIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Wellness Center, LLC Clinical CurrentSince Dec 1, 2020 Accepting new patients
Gershon Psychological Associates, LLC PastSince Apr 1, 2013 Accepting new patients
Child and Family Psychiatry, Inc. PastSince Apr 28, 2024 Accepting new patients
The Providence Center Past Accepting new patients

Locations

100 Washington St
Unit 767
West Warwick, RI 02893
Phone (508) 386-2094

Organizations & group practices 4

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": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1487987863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BALD HILL ROAD",
            "address_2": "SUITE 530",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-349-3131",
            "fax_number": "401-921-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BALD HILL ROAD",
            "address_2": "SUITE 530",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-349-3131",
            "fax_number": "401-921-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUCCI",
        "first_name": "CHRISTINA",
        "middle_name": "MEI-CHIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11999213",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "FUCCI",
            "credential": "PSY.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.