JYOTHI VAYALAKKARA (NPI# 1558449660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558449660 |
| Entity Type | Individual |
| Full Name | JYOTHI VAYALAKKARA |
| Credential | PSY.D. |
| Practice Address |
152 Deming St Providercare Plus, PC South Windsor CT 06074-3740 |
| Practice Telephone | 8606444472 |
| Practice Fax Number | 8606443001 |
| Mailing Telephone | 8606444472 |
| Mailing Fax Number | 8606443001 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | 002590 | CT | Behavioral Health & Social Service Providers |
| X | 103T00000X | Psychologist | 002590 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BCBS | 060002590CT01 | 01 |
| Street Address |
152 DEMING ST PROVIDERCARE PLUS, PC |
| City | SOUTH WINDSOR |
| State | CT |
| Zip Code | 06074-3740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891772844 | Philip S. Cardamone | Psychologist | 152 Deming St, Providercare Plus, South Windsor, CT 06074-3740 | 2005-12-29 |
| 1437782927 | Mckay Family Therapy, LLC | Marriage & Family Therapist | 152 Deming St, South Windsor, CT 06074-3740 | 2020-02-13 |
| 1124675293 | Timothy Robert Mckay | Marriage & Family Therapist | 152 Deming St, South Windsor, CT 06074-3740 | 2019-08-22 |
| 1922472992 | Playworks Therapy for Children, LLC | Social Worker | 152 Deming St, South Windsor, CT 06074-3740 | 2015-11-13 |
| 1598131989 | Mary G G Machell | Social Worker | 152 Deming St, South Windsor, CT 06074-3740 | 2015-08-19 |
| 1699066217 | Kathleen Hanley-hochdorfer | Psychologist | 152 Deming St, South Windsor, CT 06074-3740 | 2011-04-30 |
| 1548439359 | Jacqueline C. Newhouse | Social Worker | 152 Deming St, South Windsor, CT 06074-3740 | 2008-02-26 |
| 1144302431 | Melissa Claire Sheardwright | Psychologist | 152 Deming St, South Windsor, CT 06074-3740 | 2006-10-19 |
| 1396724811 | Providercare Plus PC | Psychologist | 152 Deming St, Providercare Plus, South Windsor, CT 06074-3740 | 2006-01-12 |
| 1891774360 | Vincent A Covino | Psychologist | 152 Deming St, Providercare Plus, South Windsor, CT 06074-3740 | 2006-01-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144919 | Russo Therapeutics, LLC | Occupational Therapist | 561 King Street, South Windsor, CT 06074 | 2020-05-04 |
| 1144706631 | Chana Judith Hoagland | Nurse Practitioner | 276 Quarry Brook Drive, South Windsor, CT 06074 | 2018-07-17 |
| 1093203291 | Climb Medical Group LLC | Counselor | 828 Sullivan Ave Ste A, South Windsor, CT 06074 | 2018-04-24 |
| 1528506516 | William P Guinan, Md and Associates LLC | Obstetrics & Gynecology | 25 Oakland Road, South Windsor, CT 06074 | 2017-02-09 |
| 1487027678 | Nadine Caron | Nurse Practitioner | 34 Pleasant Valley Rd, South Windsor, CT 06074 | 2015-11-10 |
| 1275957920 | Ellen Carol Ronsivalli | Dietitian, Registered | 70 High Street, South Windsor, CT 06074 | 2014-02-14 |
| 1881036457 | Chandra Yellinedi | Pharmacist | 55 Frazer Fir, South Windsor, CT 06074 | 2013-07-24 |
| 1144665969 | Brian Thomas Moy | Internal Medicine | 2400 Tamarack Ave Ste 101, South Windsor, CT 06074 | 2013-05-07 |
| 1093072886 | Lydia Lormand | Obstetrics & Gynecology | 2600 Tamarack Ave Ste 200, South Windsor, CT 06074 | 2012-04-18 |
| 1578847307 | International Institute for Professional Development, LLC | Social Worker | 435 Buckland Hills Road, South Windsor, CT 06074 | 2011-09-28 |
| Find all providers in zip 06074 | ||||
| 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 | SOUTH WINDSOR |
| Zip Code | 06074 |
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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.