JONATHAN FREDERICK MICHAELIS (NPI# 1124164231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124164231 |
| Entity Type | Individual |
| Full Name | JONATHAN FREDERICK MICHAELIS |
| Credential | PH.D. |
| Practice Address |
209 Main St Suite A Southington CT 06489-2539 |
| Mailing Address |
209 Main Street Suite A Southington CT 06489 |
| Practice Telephone | 2032162036 |
| Practice Fax Number | 8606215169 |
| Mailing Telephone | 2032162036 |
| Mailing Fax Number | 8606215169 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2009-06-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 001477 | CT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568931335 | Jonathan Fletcher Michaelis | Physician Assistant | 13020 Livingston Rd Ste 14, Naples, FL 34105-5023 | 2018-11-21 |
| Street Address |
209 MAIN ST SUITE A |
| City | SOUTHINGTON |
| State | CT |
| Zip Code | 06489-2539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902275480 | Lisa A Burk | Nurse Practitioner | 209 Main St, Southington, CT 06489-2539 | 2015-09-15 |
| 1235463845 | Clinical Bridge | Psychologist | 209 Main St, Southington, CT 06489-2539 | 2009-09-29 |
| 1659585149 | Southington Pediatric Associates LLC | Pediatrics | 209 Main St, 1st Floor, Southington, CT 06489 | 2007-05-10 |
| 1063548428 | Mary K Peterson | Pediatrics | 209 Main St, Southington, CT 06484 | 2007-02-27 |
| 1184647380 | George Skarvinko | Pediatrics | 209 Main St, Southington, CT 06489 | 2006-07-26 |
| 1104804541 | Katarzyna J. Wadolowski | Internal Medicine | 209 Main St, Southington, CT 06489 | 2006-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467087783 | Shankar Panwar | Counselor | K 11, 1783 Meriden Waterbury Tpke, Southington, CT 06489 | 2020-03-06 |
| 1235771056 | Kathleen Rebecca Mckinney | Music Therapist | 196 Queen St., Southington, CT 06489 | 2019-10-14 |
| 1336700103 | Julie Amanda Nichols | Behavioral Analyst | 1842 Meriden-waterbury Turnpike, Southington, CT 06489 | 2019-06-24 |
| 1396238960 | Kriston Ronalter | Physician Assistant | 775 Queen Street, Southington, CT 06489 | 2018-06-08 |
| 1366933582 | Cj's Counseling, LLC | Counselor | 17 Meriden Ave Ste 1a, Southington, CT 06489 | 2018-05-23 |
| 1104329887 | Koby Douglas Fowler | Chiropractor | 1095 West St Unit 1, Southington, CT 06489 | 2018-03-09 |
| 1447763131 | Samreen, LLC | Clinic/Center | 775 Queen St, Suite 2, Southington, CT 06489 | 2017-11-16 |
| 1902320724 | Michael Petit | Physical Therapist | 98 Main Street, 202, Southington, CT 06489 | 2017-08-02 |
| 1457712127 | Leslie Mclaughlin | Speech-Language Pathologist | 400 Flanders Rd, Southington, CT 06489 | 2016-03-09 |
| 1306219159 | Breanne Schnepf-hanbury | Counselor | 26 N Main St Ste 2b, Southington, CT 06489 | 2015-11-02 |
| Find all providers in zip 06489 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548761224 | Shumita Roy | Clinical Neuropsychologist | 18 N Main St Fl 2, West Hartford, CT 06107-1970 | 2018-02-27 |
| 1992216790 | Brisman Associates In Neuropsychology, Pllc | Clinical Neuropsychologist | 433 S Main St Ste 225, West Hartford, CT 06110-2812 | 2017-10-19 |
| 1083157556 | Eva Troyb | Clinical Neuropsychologist | 26 Hawks Lndg, Amston, CT 06231-1659 | 2016-11-30 |
| 1669824702 | Martin D Oliveira Psy D LLC | Clinical Neuropsychologist | 10 N Main St Ste 1, West Hartford, CT 06107-1968 | 2016-07-12 |
| 1497151245 | Connecticut Neuropsychological Associates, LLC | Clinical Neuropsychologist | 40 Connecticut Ave, Norwich, CT 06360-1502 | 2014-11-06 |
| 1750795647 | James W. Pier, Ph.d., LLC | Clinical Neuropsychologist | 700 West Johnson Ave., Suite #310, Cheshire, CT 06410 | 2014-06-18 |
| 1922424175 | Psych Solutions LLC | Clinical Neuropsychologist | 2795 Albany Ave, West Hartford, CT 06117-1804 | 2014-03-12 |
| 1194157313 | Ginger Mills | Clinical Neuropsychologist | 623 Newfield Ave, Stamford, CT 06905-3302 | 2013-07-30 |
| 1144561051 | Western Connecticut Behavioral Health | Clinical Neuropsychologist | 828 Federal Rd, 2nd Floor, Brookfield, CT 06804-1830 | 2013-03-04 |
| 1043569288 | David Porrino | Clinical Neuropsychologist | 85 Old Kings Hwy N Fl 2, Darien, CT 06820-4732 | 2012-09-04 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHINGTON |
| Zip Code | 06489 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.