Active NPI
Ellen Preen, PSY.D.
- Clinical Neuropsychologist
- Avon, CT
National Provider Identifier
1003049354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 002894
- Practice address
- 40 Dale Rd Ste 204
Avon, CT 06001-3692 - Phone
- (860) 677-7300
- NPI assigned
- Sep 2, 2009
- Last updated
- Sep 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 002894 | CT | Primary |
Addresses
Primary practice location
40 Dale Rd Ste 204
Avon, CT 06001-3692
Mailing address
40 Dale Rd Ste 204
Avon, CT 06001-3692
Phone (860) 677-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002894 | CT | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Physicians PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Farmington, CT
- NPI 1720194053
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251849600000",
"number": "1003049354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 DALE RD STE 204",
"city": "AVON",
"state": "CT",
"postal_code": "060013692",
"telephone_number": "860-677-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 DALE RD STE 204",
"city": "AVON",
"state": "CT",
"postal_code": "060013692",
"telephone_number": "860-677-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREEN",
"first_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-02",
"last_updated": "2009-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CT",
"license": "002894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.