Deer Creek Psychological Associates, PA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

DEER CREEK PSYCHOLOGICAL ASSOCIATES, PA

Practice address

45 Lyme Rd
Suite 202a
Hanover, NH 03755-1219

Phone

(802) 785-2543

Fax

(802) 785-2631

NPI assigned

Aug 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Raymond J. Chin, PHDNPI 1417060963

Title

President

Phone

(603) 643-9252

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rhea M. McKay, PSYD

  • Clinical Psychologist
  • Hanover, NH
  • NPI 1245343698
  Medicare reassignment
• Raymond J. Chin, PHD, MFA

  • Clinical Psychologist
  • Hanover, NH
  • NPI 1417060963
  NPD (past) Authorized official
• Thomas B. Gamble, PHD

  • Clinical Psychologist
  • Hanover, NH
  • NPI 1164535530
  NPD (past)
• Victoria Rhodin, MSW

  • Clinical Social Worker
  • Sharon, VT
  • NPI 1740342559
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1992818439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 266",
            "city": "EAST THETFORD",
            "state": "VT",
            "postal_code": "050430266",
            "telephone_number": "802-785-2903",
            "fax_number": "802-785-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 LYME RD",
            "address_2": "SUITE 202A",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551219",
            "telephone_number": "802-785-2543",
            "fax_number": "802-785-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER CREEK PSYCHOLOGICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "CHIN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-643-9252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VT BLUECROSS BLUESHIELD",
            "identifier": "062-19470",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "50Y303300VT01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Darcy, D.O.
• Tracey J Darling, RDH
• Dartmouth Medical School
• Renee E Davis, LADC, LMHC
• Paul M Decker, DDS
• Christine Carney Demment, PH.D.
• Bryant D Denk, DDS
• Michael R. Derosier, ATC
• Jennifer Dexter, FNP
• Timothy Michael Digiacomo, PSY.D.

• Mental Health Counselor in Hanover, NH
• Providers in Hanover, NH by specialty
• Mental Health Counselor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.