Individual provider Active NPI

Grace Cushman, PHD

  • Clinical Psychologist
  • Providence, RI
National Provider Identifier
1881459931
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS02235 Issued in RI
Practice address
1 Hoppin St Ste 204
Providence, RI 02903-4141
Phone
(401) 444-2747
NPI assigned
Feb 19, 2024
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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 PS02235 RI Primary

Addresses

Primary practice location

1 Hoppin St Ste 204
Providence, RI 02903-4141

Mailing address

1 Hoppin St Ste 204
Providence, RI 02903-4141

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
I20240611000153 RI Practitioner - Clinical Psychologist 1355883984 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS02235RIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Emma Pendleton Bradley Hospital CurrentSince Jun 1, 2024 Accepting new patients
Lifespan Physician Group, Inc. Clinical CurrentSince Jun 1, 2024 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Emma Pendleton Bradley Hospital CurrentSince Jun 1, 2024 Accepting new patients
Rhode Island Hospital Clinical CurrentSince Jun 1, 2024 Accepting new patients
Rhode Island Hospital CurrentSince Jun 1, 2024 Accepting new patients

Locations

1 Hoppin St
Ste 204
Providence, RI 02903
Phone (401) 444-8945

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

593 Eddy St
Providence, RI 02903

593 Eddy St
Lowr
Providence, RI 02903
Phone (401) 444-4471

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

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

Organizations & group practices 6

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": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1881459931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOPPIN ST STE 204",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPPIN ST STE 204",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034141",
            "telephone_number": "401-444-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHMAN",
        "first_name": "GRACE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS02235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.