CONNECTICUT NEUROPSYCHOLOGICAL ASSOCIATES, LLC (NPI# 1497151245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497151245 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT NEUROPSYCHOLOGICAL ASSOCIATES, LLC |
| Other Organization Name | CLARUS HEALTH ALLIANCE |
| Practice Address |
40 Connecticut Ave Norwich CT 06360-1502 |
| Practice Telephone | 8608897274 |
| Practice Fax Number | 8608892131 |
| Mailing Telephone | 8608897274 |
| Mailing Fax Number | 8608892131 |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2017-05-08 |
| Authorized Official Name | DR. CALEB PECK (MANAGER/OWNER) |
| Authorized Official Telephone | 8608897274 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | 003313 | CT | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 003313 | CT | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
003357 | CT | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
003313 | CT | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Clarus Health Alliance | Doing Business As Name - Organization |
| Street Address |
40 CONNECTICUT AVE |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-1502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211043 | Michela Muggeo | Psychologist | 40 Connecticut Ave, Norwich, CT 06360-1502 | 2018-07-16 |
| 1013410315 | Randolph Brooks | Counselor | 40 Connecticut Ave, Norwich, CT 06360-1502 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
| Find all providers in zip 06360 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316175540 | Ronald L Hedgepeth | Psychologist | 511 Route 132, Norwich, VT 05055-9311 | 2009-06-25 |
| 1013189216 | Diana S. Greywolf | Psychologist | 221 Route 5 S, Suite 1, Norwich, VT 05055-9523 | 2008-03-27 |
| 1942303938 | Eleanor J Anderson | Psychologist | 289 Main Street, The Burton House, Norwich, VT 05055 | 2006-09-06 |
| 1346250503 | Mark Vogel | Psychologist | 60 Midland Dr, Norwich, NY 13815-1947 | 2006-08-09 |
| 1861410888 | Mary Christine Crenshaw | Psychologist | 11 Beaver Meadow Rd, Norwich, VT 05055-9305 | 2006-07-17 |
| 1760416101 | Gosha Donnelly | Psychologist | 11 Beaver Meadow Road, Suite 4, Office 2, Norwich, VT 05055 | 2006-07-10 |
| 1295211043 | Michela Muggeo | Psychologist | 40 Connecticut Ave, Norwich, CT 06360-1502 | 2018-07-16 |
| 1699007989 | Cynthia R Dale | Psychologist | 484 Main Street, Norwich, VT 05055 | 2010-02-11 |
| 1073729398 | Monica Jane Descamps | Psychologist | 295 Main St, 2nd Fl, Norwich, VT 05055-9321 | 2007-05-15 |
| 1831218049 | Lori Jannen | Psychologist | 11 Beaver Meadow Road, Norwich, VT 05055 | 2007-03-28 |
| Find all providers in NORWICH | ||||
Please comment or provide details below to improve the information on CONNECTICUT NEUROPSYCHOLOGICAL ASSOCIATES, LLC.
| 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.