NPIMap

Organization Active NPI

Psychological Associates of Warwick II, LLC

  • Clinical Psychologist
  • Warwick, RI
National Provider Identifier
1619428422
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01524 Issued in RI
Legal business name
PSYCHOLOGICAL ASSOCIATES OF WARWICK II, LLC
Practice address
889 Centerville Rd
Warwick, RI 02886-4342
Phone
(401) 826-8875
Fax
(401) 823-9180
NPI assigned
Oct 17, 2016
Last updated
Oct 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Dr. Braden Joephson, PH.D.
Title
Owner/Psychologist
Phone
(917) 776-5433

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS01524 RI Primary
Clinical Social Worker 1041C0700X ISW01666 RI
Assistant Behavior Analyst 106E00000X LBA00074 RI

Addresses

Primary practice location

889 Centerville Rd
Warwick, RI 02886-4342

Mailing address

889 Centerville Rd
Warwick, RI 02886-4342
Phone (401) 826-8875

Other identifiers 2

IdentifierTypeStateIssuer
1101520OtherRINEIGHBORHOOD HEALTH BEACON HEALTH OPTIONS
0000003916OtherRIBLUE CROSS AND BLUE SHIELD OF RI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1619428422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 CENTERVILLE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864342",
            "telephone_number": "401-826-8875",
            "fax_number": "401-823-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 CENTERVILLE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864342",
            "telephone_number": "401-826-8875",
            "fax_number": "401-823-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL ASSOCIATES OF WARWICK II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "JOEPHSON",
        "authorized_official_first_name": "BRADEN",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "917-776-5433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01524",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01666",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "RI",
            "license": "LBA00074",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH BEACON HEALTH OPTIONS",
            "identifier": "1101520",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF RI",
            "identifier": "0000003916",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.