Individual provider Active NPI

Kathryn Ann Lachance, PHD

  • Clinical Psychologist
  • Riverside, RI
National Provider Identifier
1710501606
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS02119 Issued in RI
Practice address
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone
(401) 432-1000
NPI assigned
Jun 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 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 PS02119 RI Primary

Addresses

Primary practice location

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061

Mailing address

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone (401) 432-1000

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
I20221201001821 RI Practitioner - Clinical Psychologist 5799153326 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS02119RIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Oct 24, 2022 Accepting new patients
Emma Pendleton Bradley Hospital CurrentSince Oct 24, 2022 Accepting new patients
Lifespan Physician Group, Inc. Clinical CurrentSince Oct 24, 2022 Accepting new patients
Emma Pendleton Bradley Hospital CurrentSince Oct 24, 2022 Accepting new patients

Locations

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Providence, RI 02903

1011 Veterans Memorial Pkwy
Riverside, RI 02915
Phone (401) 432-1000

Organizations & group practices 4

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": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1710501606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACHANCE",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS02119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.