Matthew Tanner

Individual provider Active NPI Clinical Psychologist · North Kingstown, RI

NPI 1972224830 · NPPES record last updated Sep 2, 2025

Key facts

NPI
1972224830
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PS02323 (RI)
Practice address
1130 Ten Rod Rd Ste 101
North Kingstown, RI 02852-4161
Phone
(401) 294-6900
NPI assigned
Sep 8, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PS02323RIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriele Hughes Ms, PCNS, Inc. Current
since Sep 8, 2025
Accepting new patients
Ican, LLC Past
since Sep 8, 2025
Accepting new patients
Luk Crisis Center Inc. Past
since Sep 1, 2022
Accepting new patients

Locations

1130 Ten Rod Rd
Ste 101
North Kingstown, RI 02852
Phone (401) 294-3990

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/luk/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS02323 RI Yes

Addresses

Primary practice location

1130 Ten Rod Rd Ste 101
North Kingstown, RI 02852-4161

Mailing address

1130 Ten Rod Rd Ste 101
North Kingstown, RI 02852-4161

Other providers in North Kingstown, RI

All providers in North Kingstown, RI · Clinical Psychologist in Rhode Island

Sources for this page

Verify at the official NPI Registry.