Active NPI
Peter Gregory Erickson, PH.D.
- Counseling Psychologist
- Providence, RI
National Provider Identifier
1639218175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PS453
- Practice address
- 184 Waterman St
Suite 209
Providence, RI 02906-4051 - Phone
- (401) 831-5120
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PS453 | RI | Primary |
Addresses
Primary practice location
184 Waterman St
Suite 209
Providence, RI 02906-4051
Mailing address
184 Waterman St
Suite 209
Providence, RI 02906-4051
Phone (401) 831-5120
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120403000018 | RI | Practitioner - Clinical Psychologist | 0345400131 | Practice locations: Providence, RI |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
184 Waterman St
Providence, RI 02906-4051
Phone 40183151200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS453 | RI | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220832000000",
"number": "1639218175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "184 WATERMAN ST",
"address_2": "SUITE 209",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064051",
"telephone_number": "401-831-5120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "184 WATERMAN ST",
"address_2": "SUITE 209",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064051",
"telephone_number": "401-831-5120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "PETER",
"middle_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2008-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "RI",
"license": "PS453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
- Amy Lee Erdman, NP
- Eric Newton MD LLC
- Erica R. Tsai, MD, Ms, LLC
- Kathryn Kelly Erickson-Ridout, M.D.
- Allan Douglas Erickson, M.D.
- Debra A Ericksonowens, CNM
- Shannon Marie Erisman, PHD
- Ernest P. Votolato, D.M.D. & Frank a. Pazienza, D.D.S., Inc.
- Susan S. Erstling, PH.D., LICSW
- Samantha Dianne Erwin, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.