JACK HOWARD NASSAU PHD
NPI 1750367868
Psychologist - Clinical Child & Adolescent in Providence, RI

Q: What is the provider's specialty?

The provider's specialty is Psychologist with taxonomy code 103TC2200X and a focus in Clinical Child & Adolescent.

Active since December 20, 2005

1 HOPPIN ST, SUITE 204, PROVIDENCE, RI 02903(401) 444-8945(401) 444-8742 Get Directions Write a Review

NPPES record last updated: January 19, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Psychologist
Clinical Child & Adolescent

About JACK NASSAU

This page provides the complete NPI Profile along with additional information for Jack Nassau, a provider established in Providence, Rhode Island with a medical specialization in Psychologist, focusing in clinical child & adolescent . The healthcare provider is registered in the NPI registry with number 1750367868 assigned on December 2005. The practitioner's primary taxonomy code is 103TC2200X with license number PS00644 (RI). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI: 1750367868 Verify this NPI
Provider Name: JACK HOWARD NASSAU PHD
Gender: Male
Entity Type: Individual
Location Address: 1 HOPPIN ST SUITE 204 PROVIDENCE, RI 02903
Location Phone: (401) 444-8945
Location Fax: (401) 444-8742
Mailing Address: 593 EDDY ST APC 978 PROVIDENCE, RI 02903
Mailing Phone: (401) 444-4318
Mailing Fax: (401) 444-7865
Is Sole Proprietor?: No
Enumeration Date: 12-20-2005
Last Update Date: 01-19-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Psychologist Clinical Child & Adolescent
Taxonomy Code: 103TC2200X
Type: Behavioral Health & Social Service Providers
License No.: PS00644
License State: RI
Taxonomy Description: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	103TC0700X	Behavioral Health & Social Service Providers	Psychologist Clinical	PS00644 (RI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
S95858	MEDICARE UPIN (02)
007007539	MEDICARE ID-TYPE UNSPECIFIED (04)

Other Providers at the Same Location

The following 20 providers are registered at the same or a nearby location.

WILLIAM T MASON M.D.

Internal Medicine

1 HOPPIN ST, 3RD FLOOR
PROVIDENCE, RI 02903

Providence County (401) 793-8400

ELIZABETH D BUCKLEY PA

Physician Assistant

1 HOPPIN ST, 3RD FLOOR
PROVIDENCE, RI 02903

Providence County (401) 793-8400

JULIE BOERGERS PHD