Individual provider Active NPI

Richard Labrie, PSY.D.

  • Clinical Psychologist
  • Pasadena, CA
National Provider Identifier
1629403043
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28600 Issued in CA
Practice address
65 N Madison Ave Ste 707
Pasadena, CA 91101-2046
Phone
(626) 817-6665
NPI assigned
Sep 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PSY28600 CA Primary

Addresses

Primary practice location

65 N Madison Ave Ste 707
Pasadena, CA 91101-2046

Mailing address

65 N Madison Ave Ste 707
Pasadena, CA 91101-2046
Phone (626) 817-6665

Other practice location 1

33 S Catalina Ave
Suite 204
Pasadena, CA 91106-2426
Phone (626) 817-6665

Other identifiers 2

IdentifierTypeStateIssuer
7068MedicaidCA
7420MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170823004056 CA Practitioner - Clinical Psychologist 4981976123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

65 N Madison Ave
Suite 707
Pasadena, CA 91101-2046
Phone (626) 817-6665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY28600CAMDClinical Psychologist
28600CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Weal Inc a Professional Psychological Corp Clinical CurrentSince Jul 24, 2017 Accepting new patients

Locations

65 N Madison Ave
Ste 707
Pasadena, CA 91101
Phone (626) 765-7556

33 S Catalina Ave
Ste 204
Pasadena, CA 91106
Phone (626) 676-8056

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": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629403043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N MADISON AVE STE 707",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012046",
            "telephone_number": "626-817-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N MADISON AVE STE 707",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012046",
            "telephone_number": "626-817-6665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 S Catalina Ave",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911062426",
            "country_code": "US",
            "telephone_number": "626-817-6665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LABRIE",
        "first_name": "RICHARD",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.