Ilse Deyanira Carrizales, PH.D., CCFC
Individual provider Active NPI Clinical Psychologist · Riverside, RI
NPI 1962844894 · NPPES record last updated Oct 19, 2022
Key facts
- NPI
- 1962844894
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PS02094 (RI)
- Practice address
- 1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061 - Phone
- (401) 432-1000
- NPI assigned
- Jul 19, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS02094 | RI | Yes |
Addresses
Primary practice location
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Mailing address
117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779
Other providers in Riverside, RI
- Nair C Cardoso
- Care Resource, LLC
- Care Resource, LLC
- Raquel M. Carneiro
- Allison Marie Carreiro
- E. Jane Carter
- Stephen S. Cary
- Brady Geronimo Case
- Stephanie Catanese
- Kathleen McNaughtan Cawley
All providers in Riverside, RI · Clinical Psychologist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.