Healthcare Provider Details

I. General information

NPI: 1023173499
Provider Name (Legal Business Name): PSYCHOLOGICAL SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 PARK AVE SUITE 213
CRANSTON RI
02910-3227
US

IV. Provider business mailing address

57 KNOTTY OAK SHRS
COVENTRY RI
02816-7940
US

V. Phone/Fax

Practice location:
  • Phone: 401-808-0070
  • Fax:
Mailing address:
  • Phone: 401-615-5384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS00945
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS00945
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPS00945
License Number StateRI
# 4
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPS00945
License Number StateRI

VIII. Authorized Official

Name: DR. ANDREA MELINDA CHAIT
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 401-615-5384