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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

EAST BAY PSYCHOLOGICAL SERVICES LLC
NPI 1790662732
Psychologist - Clinical in Providence, RI

Active since August 20, 2025
331 WATERMAN STREET 1, RICHMOND SQ STE 130C, PROVIDENCE, RI 02906(914) 427-5640 Get Directions Write a Review

NPPES record last updated: October 9, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About East Bay Psychological Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST BAY PSYCHOLOGICAL SERVICES LLC (NPI 1790662732) is a healthcare organization registered as a clinical in Providence, Rhode Island and active in the NPI registry since August 2025. The organization lists Mark E. Kilmer, Owner, as its authorized official.

NPPES Registry Identity

NPI1790662732
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameEAST BAY PSYCHOLOGICAL SERVICES LLC
Location Address331 WATERMAN STREET 1, RICHMOND SQ STE 130CProvidence, RI 02906-5155
Mailing Address331 Waterman Street 1, Richmond Sq Ste 130cProvidence, RI 02906-5155 · (914) 427-5640
Phone(914) 427-5640
Organization SubpartNo
Authorized OfficialMark E. KilmerOwner · (914) 427-5640
Enumeration DateAugust 20, 2025
Last NPPES UpdateOctober 9, 2026
NPPES CertifiedOctober 6, 2026
✔ NPI 1790662732 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
331 WATERMAN STREET 1, Providence, RI 02906
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

East Bay Psychological Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to East Bay Psychological Services LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mark Kilmer, PHD
Clinical Psychologist
NPI 1588688600
513 BROADWAY
Newport, RI 02840
(303) 995-1188
✔ PECOS23 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Bay Psychological Services LLC's NPI number?

The NPI number for East Bay Psychological Services LLC is 1790662732. It was assigned to this organization in the NPPES registry on August 20, 2025.

Where is East Bay Psychological Services LLC located?

East Bay Psychological Services LLC is located at 331 Waterman Street 1 Richmond Sq Ste 130C, Providence, RI 02906. The listed phone number is (914) 427-5640.

What is East Bay Psychological Services LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is East Bay Psychological Services LLC enrolled in Medicare?

Yes. East Bay Psychological Services LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East Bay Psychological Services LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to East Bay Psychological Services LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for East Bay Psychological Services LLC was last updated on October 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.