| Trident Psychological Services | |
|
172 Taunton Ave Ste 208 East Providence RI 02914-4541 | |
| (401) 450-0729 | |
| (401) 537-1830 |
| Full Name | Trident Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 172 Taunton Ave Ste 208, East Providence, Rhode Island |
| Authorized Official Name and Position | Darren William Holowka (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 4014500729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trident Psychological Services 172 Taunton Ave Ste 208 East Providence RI 02914-4541 Ph: (401) 450-0729 | Trident Psychological Services 172 Taunton Ave Ste 208 East Providence RI 02914-4541 Ph: (401) 450-0729 |
| NPI Number | 1306358239 |
|---|---|
| Provider Enumeration Date | 11/01/2017 |
| Last Update Date | 11/01/2017 |
| Medicare PECOS PAC ID | 4789940537 |
|---|---|
| Medicare Enrollment ID | O20171110000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306358239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Darren W Holowka |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104187251 PECOS PAC ID: 0749428662 Enrollment ID: I20140402001494 |
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