Individual provider Active NPI

Amy Elizabeth Vitali Allen, PH.D.

  • Clinical Psychologist
  • Barrington, RI
National Provider Identifier
1710424080
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01820 Issued in RI
Practice address
60 Bay Spring Ave Unit B5
Barrington, RI 02806-1386
Phone
(401) 294-0451
Fax
(401) 294-0461
NPI assigned
Jan 25, 2017
Last updated
Aug 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20042888A IN
Clinical Psychologist 103TC0700X PS01820 RI Primary

Addresses

Primary practice location

60 Bay Spring Ave Unit B5
Barrington, RI 02806-1386

Mailing address

60 Bay Spring Ave Unit B5
Barrington, RI 02806-1386
Phone (401) 294-0451

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
I20201103002008 RI Practitioner - Clinical Psychologist 5597175521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20042888AINMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. PastSince Jun 1, 2020 Accepting new patients

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, 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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1710424080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 BAY SPRING AVE UNIT B5",
            "city": "BARRINGTON",
            "state": "RI",
            "postal_code": "028061386",
            "telephone_number": "401-294-0451",
            "fax_number": "401-294-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BAY SPRING AVE UNIT B5",
            "city": "BARRINGTON",
            "state": "RI",
            "postal_code": "028061386",
            "telephone_number": "401-294-0451",
            "fax_number": "401-294-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "AMY",
        "middle_name": "ELIZABETH VITALI",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20042888A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, RI

Sources for this page

Verify at the official NPI Registry.