Micheline Ruth Anderson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS02142 Issued in RI

Practice address

146 W River St FL 3
Providence, RI 02904-2609

Phone

(401) 793-5700

NPI assigned

Apr 7, 2023

Last updated

Jun 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifespan Physician Group IncGroup PAC ID 2567455082, shared by 4 NPIs, 1,151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793

  Clinical

  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1861187676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 W RIVER ST FL 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042609",
            "telephone_number": "401-793-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MICHELINE",
        "middle_name": "RUTH",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS02142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Anderson, M.D.
• Kathryn Margaret Anderson, MD
• Kristin L Anderson, MD
• Kyle Anderson
• Lauren Frances Anderson
• Shelley Vicky Anderson, OT
• Thea Anderson, MD
• Ashley P Andrade, FNP-C
• Christine L Andrade, LCSW
• Robin Charland Andrade, MS CCC-SLP

• Clinical Psychologist in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Psychologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.