MEDICARE: DR. TERENCE CHING PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	004471	CT

General Provider Information

NPI Number	:	1306799069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERENCE CHING PHD

Provider Business Mailing Address
First Line	:	761 WOLCOTT ST
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-5918
Country	:	US
Telephone Number	:	502-612-1127
Fax Number	:

Provider Business Practice Location Address
First Line	:	761 WOLCOTT ST
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-5918
Country	:	US
Telephone Number	:	502-612-1127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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