East Bay Psychological Services LLC
NPI 1790662732ActiveOrganization· Psychologist, Clinical· Providence, RI
Psychologist, Clinical in Providence, Rhode Island, registered in NPPES in August 2025. The authorized official on file is Mark E. Kilmer, PHD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1790662732 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 20, 2025 |
| Last updated in NPPES | Oct 9, 2026 |
| Certified by provider | Oct 6, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
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) | Enrolled Part B Supplier - Clinic/Group Practice (RI) |
|---|
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