Mina Chung, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS01018 Issued in RI

Practice address

205 Waterman St Ste 203
Providence, RI 02906-4313

Phone

(401) 326-2845

NPI assigned

Jun 19, 2007

Last updated

Mar 21, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1609071703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 COUNTY RD",
            "city": "BARRINGTON",
            "state": "RI",
            "postal_code": "028064502",
            "telephone_number": "401-340-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WATERMAN ST STE 203",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064313",
            "telephone_number": "401-326-2845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "154 Waterman St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029063116",
            "country_code": "US",
            "telephone_number": "510-499-4768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Richmond Sq",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029065139",
            "country_code": "US",
            "telephone_number": "401-326-2845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Richmond Sq Ste 103K",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029065166",
            "country_code": "US",
            "telephone_number": "401-326-2845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan Chun
• Thomas Chun, MD
• Tristen Chun, M.D.
• Dean Chung, MD
• Erica Chung, M.D.
• Winnie Chung, MD
• Lucinda Churchill, LCSW
• Ciara Byrne, PHD, LLC
• Lydia Ciarallo, MD
• Ciarniello Physical Therapy, LLC

• Clinical Psychologist in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Psychologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.