NUTMEG NEUROPSYCHOLOGY LLC (NPI# 1669962163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669962163 |
Entity Type | Organization |
Organization Name | NUTMEG NEUROPSYCHOLOGY LLC |
Practice Address |
322 Main St Ste 2e-1o Willimantic CT 06226 |
Mailing Address |
322 Main St # 2e-1o Willimantic CT 06226-3152 |
Practice Telephone | 8609317676 |
Practice Fax Number | 8609317677 |
Mailing Telephone | 8609317676 |
Mailing Fax Number | 8889277520 |
Enumeration Date | 2018-05-10 |
Last Update Date | 2018-07-10 |
Authorized Official Name | CHRISTINE YANTZ (NEUROPSYCHOLOGIST) |
Authorized Official Telephone | 8609317676 |
Authorized Official Credential | PHD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | 166336769 | 05 |
Street Address |
322 MAIN ST STE 2E-1O |
City | WILLIMANTIC |
State | CT |
Zip Code | 06226 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962663310 | Christine Yantz | Psychologist | 322 Main St Ste 2e-1o, Willimantic, CT 06226 | 2008-06-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104344365 | Taylor Girard | Social Worker | 54-56 Boston Post Road, Willimantic, CT 06226 | 2017-09-07 |
1194268490 | Donald Diange | Pharmacist | 1391 Main Street, Willimantic, CT 06226 | 2016-11-18 |
1386988954 | Gale K Lockland | Psychologist | 112 Mansfield Avenue, Windham Community Memorial Hospital, Willimantic, CT 06226 | 2012-11-20 |
1831343060 | Carlita R Baldwin | Counselor | 366 Ash Street, Unit 4, Willimantic, CT 06226 | 2008-11-14 |
1023211190 | Joel Lee Reinholtz | Physical Therapy Assistant | 595 Valley Street, Windham, CT 06226 | 2007-06-07 |
1265654719 | Mcsweeney Regional Senior Center | Clinic/Center | 47 Crescent St, Willimantic, CT 06226 | 2007-05-03 |
1912012964 | John Wescott Stevens | Dentist | 1581 W Main St, Willmantic, CT 06226 | 2006-08-20 |
1801802756 | Kathryn Nelson | Family Medicine | 355 High Street, Willimantic, CT 06226 | 2006-07-31 |
1710914379 | The Foot Group, LLC | Podiatrist | 162 A Mansfield Ave, Willimantic, CT 06226 | 2006-06-27 |
1689600561 | Leszek A Kolodziejczak | Surgery | 162 Mansfield Ave., B, Willimantic, CT 06226 | 2006-06-23 |
Find all providers in zip 06226 |
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 |
---|---|---|---|---|
1417963596 | Sarah E Bullard | Clinical Neuropsychologist | 322 Main St Ste 2e-10, Willimantic, CT 06226-3152 | 2006-07-31 |
1295194546 | River Valley Neuropsychology LLC | Clinical Neuropsychologist | 322 Main St Ste 2e-10, Willimantic, CT 06226-3152 | 2016-02-15 |
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 | WILLIMANTIC |
Zip Code | 06226 |
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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.