Individual provider Active NPI

Amy Creegan, LMFT

  • Marriage & Family Therapist
  • Lincoln, RI
National Provider Identifier
1790074441
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
00161 Issued in RI
Practice address
652 George Washington Hwy
Lincoln, RI 02865-4330
Phone
(401) 475-9979
Fax
(401) 475-9917
NPI assigned
Apr 4, 2011
Last updated
Jan 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Marriage & Family Therapist 106H00000X 00161 RI Primary

Addresses

Primary practice location

652 George Washington Hwy
Lincoln, RI 02865-4330

Mailing address

652 George Washington Hwy
Lincoln, RI 02865-4330
Phone (401) 475-9979

Other identifiers 1

IdentifierTypeStateIssuer
GH57134MedicaidRI

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
I20241122003117 RI Practitioner - Marriage and Family Therapist 0840725123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Behavioral Health LLCGroup PAC ID 4981048501, 14 clinicians

Practice addresses (Care Compare)

469 Centerville Rd
Suite 105
Warwick, RI 02886-4356
Phone (401) 773-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00161RIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Behavioral Health, LLC CurrentSince Sep 18, 2024 Accepting new patients

Locations

469 Centerville Rd
Ste 105
Warwick, RI 02886
Phone (401) 738-9200

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1790074441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 GEORGE WASHINGTON HWY",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654330",
            "telephone_number": "401-475-9979",
            "fax_number": "401-475-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 GEORGE WASHINGTON HWY",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028654330",
            "telephone_number": "401-475-9979",
            "fax_number": "401-475-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEGAN",
        "first_name": "AMY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "RI",
            "license": "00161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GH57134",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, RI

Sources for this page

Verify at the official NPI Registry.