NPIMap

Organization Active NPI

Wandembergh Mental Health Services, LLC

  • Clinical Psychologist
  • Manchester, CT
National Provider Identifier
1003071275
Registry record updated Jul 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
002846 Issued in CT
Legal business name
WANDEMBERGH MENTAL HEALTH SERVICES, LLC
Practice address
206 Wells St
Manchester, CT 06040-6152
Phone
(860) 643-5387
Fax
(860) 643-5387
NPI assigned
Jul 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Hector Chanes, PSY.D.
Title
Clinical Psychologist / President
Phone
(860) 643-5387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 002846 CT Primary

Addresses

Primary practice location

206 Wells St
Manchester, CT 06040-6152

Mailing address

206 Wells St
Manchester, CT 06040-6152
Phone (860) 643-5387

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217116800000",
    "number": "1003071275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 WELLS ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406152",
            "telephone_number": "860-643-5387",
            "fax_number": "860-643-5387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 WELLS ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406152",
            "telephone_number": "860-643-5387",
            "fax_number": "860-643-5387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANDEMBERGH MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-27",
        "last_updated": "2008-07-27",
        "status": "A",
        "authorized_official_last_name": "CHANES",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST / PRESIDENT",
        "authorized_official_telephone_number": "860-643-5387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.