SHERRI LYNN PROVENCAL


Address: 555 Prospect St, Pawtucket, RI 02860-6200
Phone: 4017296200

SHERRI LYNN PROVENCAL (NPI# 1245477785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245477785
Entity Type Individual
Full Name SHERRI LYNN PROVENCAL
Credential PH.D.
Practice Address 555 Prospect St
Pawtucket
RI 02860-6200
Practice Telephone 4017296200
Practice Fax Number 4017296203
Mailing Telephone 4017296200
Mailing Fax Number 4017296203
Enumeration Date 2009-01-20
Last Update Date 2010-07-15
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist PS01063 RI Behavioral Health & Social Service Providers

Office Location

Street Address 555 PROSPECT ST
City PAWTUCKET
State RI
Zip Code 02860-6200

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497739304 Louise S. Kiessling Pediatrics 555 Prospect St, Department of Neurodevelopmental, Pawtucket, RI 02860-6200 2005-12-05
1124437264 Meredith Amaya-hodges Clinical Neuropsychologist 555 Prospect St, Pawtucket, RI 02860-6200 2014-08-02
1326243866 Viren Andrew D'sa Pediatrics 555 Prospect St, Pawtucket, RI 02860-6200 2007-06-15
1538113113 Rhode Island Pet Services, LLC Clinic/Center 555 Prospect St, Pawtucket, RI 02860-6200 2006-05-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1972096923 Lmb Medical LLC Internal Medicine 127 School St, Pawtucket, RI 02860 2018-06-13
1215420435 Tyla Jackson Behavior Technician 70 Wood St Apt 22, Pawtucket, RI 02860 2018-06-12
1376048637 Michael A Iadevaia Family Medicine 111 Brewster St Fl 3, Pawtucket, RI 02860 2018-03-28
1730690488 Anthony Edwin Ramicone Physician Assistant 407 East Ave Ste 120, Pawtucket, RI 02860 2017-10-21
1669991352 Kathleen K. Kroessler, Md; Neurology & Acupuncture, Inc. PC Clinic/Center 407 East Ave; Suite 110, Pawtucket, RI 02860 2017-09-13
1841716230 Ri Alternative Academy Management, LLC Local Education Agency (LEA) 249 Roosevelt Avenue, Pawtucket, RI 02860 2017-08-17
1396265724 Hannah R Stoops Family Medicine 111 Brewster St Fcc A, Pawtucket, RI 02860 2017-06-27
1427578400 Shaun Michael Flynn Family Medicine 111 Brewster St, Fcc A, Pawtucket, RI 02860 2017-06-21
1073051843 Laura Jane Amaral Counselor 750 East Ave Unit 1e, Pawtucket, RI 02860 2017-02-01
1063862027 Stephanie Shoppell Counselor 105 Bacon Street, Pawtucket, RI 02860 2016-06-20
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1275668006 East Bay Neurology Professional Corporation Clinical Neuropsychologist 333 School St Ste 216, Pawtucket, RI 02860 2007-02-22
1619909108 Melissa M Amick Clinical Neuropsychologist Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860 2006-07-07
1124437264 Meredith Amaya-hodges Clinical Neuropsychologist 555 Prospect St, Pawtucket, RI 02860-6200 2014-08-02
1144643495 Rebecca Mclean Clinical Neuropsychologist 111 Brewster St, Pawtucket, RI 02860-4474 2014-01-22
1720260805 Laura Lynnette Frakey Clinical Neuropsychologist 111 Brewster Street, Pawtucket, RI 02860-4400 2007-11-30
1942224639 Janet Grace Clinical Neuropsychologist Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860 2006-07-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1689299661 Laura Elizabeth Korthauer Gilmour Clinical Neuropsychologist 110 Lockwood St Ste 430, Providence, RI 02903-4815 2020-06-15
1992339501 Carmen G Armengol Clinical Neuropsychologist 58 Rochambeau Ave, Providence, RI 02906-1908 2020-02-24
1689140121 Ef Advantage LLC Clinical Neuropsychologist 989 Reservoir Ave Ste 4, Cranston, RI 02910-5137 2018-10-23
1356833024 Natalie Rita Noonan Clinical Neuropsychologist 593 Eddy St Ste 430, Providence, RI 02903 2018-05-30
1679064935 Marlana Joyce Borgos Clinical Neuropsychologist 10 Howland Farm Rd, East Greenwich, RI 02818-2651 2018-05-22
1902329667 Neuroperformance Group, L.l.c Clinical Neuropsychologist Two Regency Plaza, Suite 3, Providence, RI 02903 2017-07-24
1871856484 Rachel K Baldwin Clinical Neuropsychologist 355 Hope Street, 2nd Floor, Unit 6, Providence, RI 02906 2012-06-19
1932338951 Melissa Perkins-banas Clinical Neuropsychologist 260 W Exchange St Ste 210, Providence, RI 02903-1000 2009-07-12
1114146958 Barbara Ann Baron Clinical Neuropsychologist 175 Progress St, Lincoln, RI 02865-3015 2007-04-24
1134136963 Jon Kimpton Clinical Neuropsychologist 481a Kingstown Rd, Wakefield, RI 02879-3607 2006-08-02
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Competitor

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City PAWTUCKET
Zip Code 02860

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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