JENNIFER SELDEN (NPI# 1477595460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477595460 |
| Entity Type | Individual |
| Full Name | JENNIFER SELDEN |
| Credential | PHD |
| Practice Address |
481 Gold Star Hwy Suite 301 Groton CT 06340 |
| Practice Telephone | 8609418579 |
| Practice Fax Number | 8608488115 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-11-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY002631 | CT | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 002631 | CT | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | PSY002631 | CT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679128128 | Jennifer Selden | Art Therapist | 46 Forest Ave, Locust Valley, NY 11560-1713 | 2019-08-01 |
| Street Address |
481 GOLD STAR HWY SUITE 301 |
| City | GROTON |
| State | CT |
| Zip Code | 06340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346246444 | Anandhi Baleswaren | Internal Medicine | 481 Gold Star Hwy, Suite 100, Groton, CT 06340-6702 | 2005-06-23 |
| 1760856181 | Kmg Therapy and Consulting LLC | Social Worker | 481 Gold Star Hwy, Suite 301, Groton, CT 06340-6702 | 2015-11-23 |
| 1780057653 | Kaileah Christie-fogg, LLC | Social Worker | 481 Gold Star Hwy, Suite 301, Groton, CT 06340-6702 | 2015-11-02 |
| 1932518008 | Sarah M Riccitelli | Physical Therapist | 481 Gold Star Hwy, Suite 302, Groton, CT 06340-6702 | 2014-08-04 |
| 1659713428 | Kla Kemp, LLC | Social Worker | 481 Gold Star Hwy, Groton, CT 06340-6702 | 2013-07-22 |
| 1972849289 | Kaileah Christie-fogg | Social Worker | 481 Gold Star Hwy, 301, Groton, CT 06340-6702 | 2012-12-14 |
| 1245592617 | Physical Therapy of Mystic, LLC | Physical Therapist | 481 Gold Star Hwy, Suite 201, Groton, CT 06340-6702 | 2012-06-12 |
| 1730400318 | Michelle Bussolotti, Lmft | Marriage & Family Therapist | 481 Gold Star Hwy, Groton, CT 06340-6702 | 2010-06-17 |
| 1437334851 | Community Health Center Inc | Family Medicine | 481 Gold Star Hwy, Suite 100, Groton, CT 06340-6702 | 2008-01-03 |
| 1952596173 | Ron A. Agostini | Physical Therapist | 481 Gold Star Hwy, Suite 201, Groton, CT 06340-6702 | 2007-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| 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 |
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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.