Active NPI
Richard Albert Gaudet, PSYD
- Psychologist
- Philadelphia, PA
National Provider Identifier
1669627477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSO 16156
- Practice address
- 535 Walnut LN
Philadelphia, PA 19128-1742 - Phone
- (215) 298-4515
- NPI assigned
- Nov 20, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSO 16156 | PA | Primary |
| Psychologist | 103T00000X | PY 00052525 | FL | |
| Forensic Psychologist | 103TF0200X | 35S100457500 | NJ |
Addresses
Primary practice location
535 Walnut LN
Philadelphia, PA 19128-1742
Mailing address
535 Walnut LN
Philadelphia, PA 19128-1742
Phone (215) 298-4515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 00052525 | FL | MD | Psychologist |
| PSO 16156 | PA | MD | Psychologist |
| 35S100457500 | NJ | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227139200000",
"number": "1669627477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 WALNUT LN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191281742",
"telephone_number": "215-298-4515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 WALNUT LN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191281742",
"telephone_number": "215-298-4515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUDET",
"first_name": "RICHARD",
"middle_name": "ALBERT",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-20",
"last_updated": "2008-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PSO 16156",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY 00052525",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "NJ",
"license": "35S100457500",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.