DR. KEITH ROEDER (NPI# 1912932294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912932294 |
| Entity Type | Individual |
| Full Name | DR. KEITH ROEDER |
| Credential | PSYD |
| Practice Address |
300 Plaza Middlesex 3rd Floor Middlesex CT 06457 |
| Practice Telephone | 8603479911 |
| Practice Fax Number | 8603478120 |
| Mailing Telephone | 8603479911 |
| Mailing Fax Number | 8603478120 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 1719 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UHC | 0567535 | 01 | |
| CT | AETNA | 4257498 | 01 |
| MAGELLAN | 708160 | 01 | |
| OXFORD | P664410 | 01 | |
| CT | 00414087800 | 05 | |
| VALUE OPTIONS | 163070 | 01 | |
| BLUE CROSS | 060001719CT01 | 01 | |
| CIGNA | 1037571 | 01 | |
| MHN | 157460 | 01 |
| Street Address |
300 PLAZA MIDDLESEX 3RD FLOOR |
| City | MIDDLESEX |
| State | CT |
| Zip Code | 06457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| 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 |
|---|---|---|---|---|
| 1598363962 | Tyrek J Pratt LLC | Psychologist | 74 New London Tpke Ste 1, Glastonbury, CT 06033-4204 | 2020-10-16 |
| 1003413493 | Dominica B Hernandez | Psychologist | 4 Doubleday Rd, Columbia, CT 06237-1405 | 2020-10-08 |
| 1861009417 | Margaret Mary Maher | Psychologist | 225 Main St # Ll, Westport, CT 06880-3216 | 2020-09-28 |
| 1831705573 | Meredith Poster | Psychologist | 6 Rustic Lane, Westport, CT 06880 | 2020-09-18 |
| 1407461619 | Kathy Yuen | Psychologist | 34 Clearview Ave, West Hartford, CT 06119-2201 | 2020-09-14 |
| 1730706912 | Albert Petitpas | Psychologist | 130 Butternut Ln, Kensington, CT 06037-1200 | 2020-07-03 |
| 1285267880 | Margaret Taylor Davis | Psychologist | 2 Church St S Ste 511, New Haven, CT 06519-1760 | 2020-02-21 |
| 1871139196 | Joseph Demers | Psychologist | 330 Post Rd, Darien, CT 06820-3600 | 2019-11-21 |
| 1063053114 | Safe Haven Psychological Services LLC | Psychologist | 491 Main St Ste D, Branford, CT 06405-3505 | 2019-09-30 |
| 1578113403 | Janet Mentore Lee | Psychologist | 124 Woodridge Dr, New Canaan, CT 06840-3511 | 2019-09-12 |
| Find all providers with the same taxonomy | ||||
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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.