Healthcare Provider Details

I. General information

NPI: 1104745835
Provider Name (Legal Business Name): JAMES BRCAK PSYCHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 BROADWAY STE 110
PROVIDENCE RI
02909-1178
US

IV. Provider business mailing address

334 BROADWAY STE 110
PROVIDENCE RI
02909-1178
US

V. Phone/Fax

Practice location:
  • Phone: 401-323-7327
  • Fax:
Mailing address:
  • Phone: 401-323-7327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES BRCAK
Title or Position: LICENSED PSYCHOLOGIST
Credential: PSY.D.
Phone: 401-323-7327