Center for Dynamic and Behavioral Therapy LLC
NPI 1790207876ActiveOrganization· Psychologist, Clinical· Providence, RI
Psychologist, Clinical in Providence, Rhode Island, registered in NPPES in July 2017. The authorized official on file is Nicole Issa, PSYD, Owner.
Overview
| NPI | 1790207876 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 11, 2017 |
| Last updated in NPPES | Jul 25, 2021 |
| Certified by provider | Jul 25, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | PS01616 | RI |
| Psychologist, Clinical | 103TC0700X | PS01615 | RI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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