DR. DANIEL RAYMOND BROCKETT (NPI# 1801921333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801921333 |
| Entity Type | Individual |
| Full Name | DR. DANIEL RAYMOND BROCKETT |
| Credential | PH.D. |
| Practice Address |
2 Pomperaug Office Park Suite 206-d Southbury CT 06488-2288 |
| Practice Telephone | 2032643050 |
| Practice Fax Number | 2032642426 |
| Mailing Telephone | 2032643050 |
| Mailing Fax Number | 2032642426 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | 001851 | CT | Behavioral Health & Social Service Providers |
| X | 103T00000X | Psychologist | 001851 | CT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609001718 | Daniel Brockett | Psychiatry & Neurology | 1350 Columbia St, San Diego, CA 92101-3454 | 2009-05-18 |
| Street Address |
2 POMPERAUG OFFICE PARK SUITE 206-D |
| City | SOUTHBURY |
| State | CT |
| Zip Code | 06488-2288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578556882 | Nancy Millian | Psychologist | 2 Pomperaug Office Park, Ste 206, Southbury, CT 06488-2291 | 2005-08-23 |
| 1801340450 | Christine Marie Cocchiola | Social Worker | 2 Pomperaug Office Park, Suite 206-a, Southbury, CT 06488-2288 | 2016-08-12 |
| 1578922290 | Ifc Counseling Services, LLC | Social Worker | 2 Pomperaug Office Park, Suite 206-c, Southbury, CT 06488-2288 | 2016-02-23 |
| 1932575610 | Southbury Audiology LLC | Audiologist | 2 Pomperaug Office Park, Suite 307, Southbury, CT 06488-2288 | 2015-08-17 |
| 1740681089 | Brittany Lee Heninger | Physical Therapist | 2 Pomperaug Office Park, Suite 303, Southbury, CT 06488-2288 | 2014-09-05 |
| 1326380031 | Jennifer C. Zaharek | Physical Therapist | 2 Pomperaug Office Park, Suite 303, Southbury, CT 06488-2292 | 2013-03-20 |
| 1659628931 | Stephanie L. Bakewell | Audiologist | 2 Pomperaug Office Park, Suite 307, Southbury, CT 06488 | 2012-08-06 |
| 1932466547 | Daniel R Brockett Phd LLC | Clinical Neuropsychologist | 2 Pomperaug Office Park, Suite 206d, Southbury, CT 06488-2288 | 2012-04-19 |
| 1972877686 | David E Miller | Physical Therapist | 2 Pomperaug Office Park, Suite 303, Southbury, CT 06488-2288 | 2012-02-27 |
| 1497035927 | Ruth Katherine Stoklosa | Physical Therapy Assistant | 2 Pomperaug Office Park, Suite 303, Southbury, CT 06488-2288 | 2011-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538646229 | Katherine Whalen | Physical Therapist | 655 Main Sreet South, Southbury, CT 06488 | 2018-07-25 |
| 1346779618 | Prestige Companion & Homemakers, LLC | Homemaker | 32 Poverty Rd, Suite F, Southbury, CT 06488 | 2017-06-08 |
| 1407225873 | Mary Synnott | Occupational Therapist | 25 Depot Hill Rd, Southbuty, CT 06488 | 2015-09-16 |
| 1568854735 | Jean Piacenza | Social Worker | 505 Heritage Road, Suite 104, Southbury, CT 06488 | 2015-02-25 |
| 1295174993 | Saeeda Qadri | Internal Medicine | 22 Old Waterbury Rd Ste 108, Southbury, CT 06488 | 2013-06-17 |
| 1538502133 | Hearing Aid Services Inc | Audiologist-Hearing Aid Fitter | 1449 Old Waterbury Rd Ste 303, Southbury, CT 06488 | 2013-04-12 |
| 1992064380 | Maria Hornak-houle | Social Worker | 88 Main St. S, Southbury, CT 06488 | 2012-05-07 |
| 1255641072 | Rebecha Kay Sullivan | Social Worker | 35 Timberland Way, Southbury, CT 06488 | 2010-10-14 |
| 1619115094 | Jennie L Kempf | Counselor | 33 Bullet Hill Rd Ste 204, Southbury, CT 06488 | 2009-01-23 |
| 1891949434 | Kelly Patrice Hochstetler | Occupational Therapist | 22 Old Waterbury Rd., Suite 101, Phys. Med. Ctr. of Southbury, Southbury, CT 06488 | 2008-11-10 |
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| 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 |
|---|---|---|---|---|
| 1679516645 | Richard H Grayson | Clinical Neuropsychologist | 7 Garage Rd, Unit D, Southbury, CT 06488-3884 | 2006-06-14 |
| 1932466547 | Daniel R Brockett Phd LLC | Clinical Neuropsychologist | 2 Pomperaug Office Park, Suite 206d, Southbury, CT 06488-2288 | 2012-04-19 |
| 1730227745 | Pediatric Neuropsychological Services, LLC | Clinical Neuropsychologist | 7 Garage Rd, Unit D, Southbury, CT 06488-3884 | 2007-02-02 |
| 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.