DAVID SHACK (NPI# 1811942402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811942402 |
| Entity Type | Individual |
| Full Name | DAVID SHACK |
| Practice Address |
270 Farmington Ave Suite 309 Farmington CT 06032-1909 |
| Mailing Address |
8 Magnolia Cir Farmington CT 06032-2049 |
| Practice Telephone | 8606775570 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 646 | CT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255889978 | David Shack | Nurse Practitioner | 75 Maiden Ln, Ste 1206, New York, NY 10038-4810 | 2016-09-12 |
| Street Address |
270 FARMINGTON AVE SUITE 309 |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06032-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609854694 | Brian N Lewton | Specialist/Technologist | 270 Farmington Ave, Suite 174, Farmington, CT 06032-1909 | 2006-01-09 |
| 1700404167 | Jemilat Joy Azeez | Nurse Practitioner | 270 Farmington Ave, Farmington, CT 06032-1909 | 2020-07-10 |
| 1992335616 | Amanda Begin | Counselor | 270 Farmington Ave, Farmington, CT 06032-1909 | 2020-01-22 |
| 1508415928 | Sam Ol Ith | Pharmacist | 270 Farmington Ave, Farmington, CT 06032-1909 | 2019-09-09 |
| 1891235198 | Angela Hay | Social Worker | 270 Farmington Ave, Suite 309, Farmington, CT 06032-1909 | 2017-03-06 |
| 1881138568 | Julia Hamilton | Social Worker | 270 Farmington Ave, Suite 309, Farmington, CT 06032-1909 | 2016-12-14 |
| 1790237402 | Helen Polewoj | Social Worker | 270 Farmington Ave, Suite 309, Farmington, CT 06032-1909 | 2016-10-28 |
| 1922550771 | D Craig Newton | Social Worker | 270 Farmington Ave, Suite 309, Farmington, CT 06032-1909 | 2016-10-27 |
| 1023565926 | Nancy Bertulis | Social Worker | 270 Farmington Ave, #309, Farmington, CT 06032-1909 | 2016-09-08 |
| 1225583420 | The Cataract Vision Institute LLC | Clinic/Center | 270 Farmington Ave, Suite 172, Farmington, CT 06032-1909 | 2016-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508499435 | Kelsey Erin Boyne | Student in an Organized Health Care Education/Training Program | 200 Academic Way, Farmington, CT 06032 | 2020-02-19 |
| 1760024723 | Baliram Maraj | Dentist | 801 Plainville Ave., Farmington, CT 06032 | 2019-10-11 |
| 1770144958 | Dominique Feterman Jimenez | Student in an Organized Health Care Education/Training Program | Internal Medicine Associates Outpatient Pavilion 2 West, 263 Farmington Avenue, Farmington, CT 06032 | 2019-06-27 |
| 1033770698 | Tiffany Otto | Nurse Practitioner | 27o Farmington Avenue, # 309, Farmington, CT 06032 | 2019-06-25 |
| 1124683941 | Aleksandra M Sliwinska | Student in an Organized Health Care Education/Training Program | Uconn Health Im Associates, 263 Farmington Avenue, Op, 2 West, Farmington, CT 06032 | 2019-05-07 |
| 1922663889 | Sean Ag Harford | Student in an Organized Health Care Education/Training Program | Uconn Health - Internal Medicine Associates, 263 Farmington Avenue, Op, 2 West, Farmington, CT 06032 | 2019-05-07 |
| 1710450507 | Kathy Jean Campbell | Occupational Therapist | 10 Birdseye Rd, Farmington, CT 06032 | 2019-01-04 |
| 1790273373 | Cameron Seymour | Dentist | 291 Farmington Ave Ste 5, Farmington, CT 06032 | 2018-04-29 |
| 1881181790 | Robin L Shahverdian LLC | Counselor | 304 Main St Ste D428, Farmington, CT 06032 | 2018-04-16 |
| 1588160998 | Sight Sensory Rehabilitation Center, Pllc | Optometrist | 10 Birdseye Road, Farmington, CT 06032 | 2018-04-04 |
| Find all providers in zip 06032 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578062295 | Megan Maureen Clarke | Psychologist | 3 Forest Park Dr Ste 101, Farmington, CT 06032-1468 | 2018-02-08 |
| 1023324316 | Faith Prelli | Psychologist | 304 Main St Ste 413, Farmington, CT 06032-2985 | 2010-08-24 |
| 1508098211 | Linda Lee Sutton Meade | Psychologist | 1016 W Columbia St, Sex Offender Rehabilitation and Treatment Services, Farmington, MO 63640-2902 | 2009-08-13 |
| 1760670962 | Emily Young Bullock | Psychologist | 240 N East Promontory Ste 200, Farmington, UT 84025-2950 | 2007-10-12 |
| 1295883353 | James Merrill Wood | Psychologist | 23629 Liberty St, Farmington, MI 48335-3568 | 2007-01-08 |
| 1083612477 | Julian Ford | Psychologist | 10 Talcott Notch, Farmington, CT 06030-0001 | 2005-07-11 |
| 1366939191 | Wellspring Psychological Services, LLC | Psychologist | 3 Forest Park Dr Ste 101, Farmington, CT 06032-1468 | 2018-04-17 |
| 1528568110 | Lynn Joy Mcmunn | Psychologist | 270 Farmington Ave Ste 309, Farmington, CT 06032-1953 | 2018-02-20 |
| 1275925117 | Onik Integrative Medicine | Psychologist | 3300 N Butler Ave, Suite 216, Farmington, NM 87401-5621 | 2015-03-02 |
| 1255762951 | John Paulino | Psychologist | 1400a E 20th St, Farmington, NM 87401-9024 | 2013-12-05 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 06032 |
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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.