Individual provider Active NPI

Nicholas Steiny Johnson, PSY.D.

  • Clinical Psychologist
  • Woonsocket, RI
National Provider Identifier
1629218193
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01250 Issued in RI
Practice address
68 Cumberland St
Suite 102
Woonsocket, RI 02895-3300
Phone
(401) 356-1940
Fax
(401) 356-1949
NPI assigned
Feb 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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 PS01250 RI Primary

Addresses

Primary practice location

68 Cumberland St
Suite 102
Woonsocket, RI 02895-3300

Mailing address

68 Cumberland St
Suite 102
Woonsocket, RI 02895-3300
Phone (401) 356-1940

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
I20170419000240 RI Practitioner - Clinical Psychologist 5799089835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plaza Psychology and Psychiatry, Inc.Group PAC ID 8628973666, 8 clinicians

Practice addresses (Care Compare)

816 Middle Rd
East Greenwich, RI 02818-1807
Phone (401) 356-1940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS01250RIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Plaza Psychology & Psychiatry, Inc. Clinical CurrentSince Nov 30, 2015 Accepting new patients

Locations

816 Middle Rd
East Greenwich, RI 02818
Phone (401) 356-1940

68 Cumberland St
Ste 102
Woonsocket, RI 02895
Phone (401) 356-1940

191 Social St
Ste 180
Woonsocket, RI 02895
Phone (401) 356-1940

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": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1629218193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 CUMBERLAND ST",
            "address_2": "SUITE 102",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953300",
            "telephone_number": "401-356-1940",
            "fax_number": "401-356-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 CUMBERLAND ST",
            "address_2": "SUITE 102",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953300",
            "telephone_number": "401-356-1940",
            "fax_number": "401-356-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICHOLAS",
        "middle_name": "STEINY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-24",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.