Individual provider Active NPI

Jason Lord

  • Psychiatric/Mental Health Nurse Practitioner
  • Cranston, RI
National Provider Identifier
1659052736
Registry record updated May 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN04537 Issued in RI
Practice address
1020 Park Ave
Cranston, RI 02910-3227
Phone
(401) 396-7649
NPI assigned
Jul 31, 2023
Last updated
May 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN03515 RI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN04537 RI Primary

Addresses

Primary practice location

1020 Park Ave
Cranston, RI 02910-3227

Mailing address

20335 Patriot Way
West Greenwich, RI 02817-6027

Other practice location 1

20335 Patriot Way
West Greenwich, RI 02817-6027
Phone (646) 270-3548

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251204001180 RI Practitioner - Nurse Practitioner 9133612468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diversity Counseling LLCGroup PAC ID 7719330034, 3 clinicians

Practice addresses (Care Compare)

1020 Park Ave
Cranston, RI 02910-3227
Phone (401) 396-7649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN03515RIMDFamily Nurse Practitioner
APRN04537RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diversity Counseling LLC CurrentSince Nov 20, 2025 Accepting new patients
Directions for Life Inc CurrentSince Nov 20, 2025 Accepting new patients
Dr Joanne L Doucette Psychological Services Inc PastSince Apr 1, 2009 Accepting new patients

Locations

1020 Park Ave
Providence, RI 02910
Phone (401) 396-7649

111 Wayland Ave
Providence, RI 02906
Phone (401) 396-7649

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780185600000",
    "number": "1659052736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20335 PATRIOT WAY",
            "city": "WEST GREENWICH",
            "state": "RI",
            "postal_code": "028176027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 PARK AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029103227",
            "telephone_number": "401-396-7649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20335 Patriot Way",
            "address_purpose": "LOCATION",
            "city": "West Greenwich",
            "state": "RI",
            "postal_code": "028176027",
            "country_code": "US",
            "telephone_number": "646-270-3548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LORD",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN03515",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN04537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.