Individual provider Active NPI

Chelsea McIntosh, PSYD

  • Clinical Psychologist
  • Stamford, CT
National Provider Identifier
1003255274
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3515 Issued in CT
Practice address
141 Franklin St
Stamford, CT 06902-5113
Phone
(203) 969-0802
Fax
(203) 316-9024
NPI assigned
Jun 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301015521 MI
Clinical Psychologist 103TC0700X 3515 CT Primary

Addresses

Primary practice location

141 Franklin St
Stamford, CT 06902-5113

Mailing address

141 Franklin St
Stamford, CT 06902-5113
Phone (203) 969-0802

Other names 1

  • Chelsea R Boska Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010000206 CT Order and Referring Only - Clinical Psychologist 6709231871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301015521MIMDPsychologist
3515CTMDClinical Psychologist

Interoperability endpoints

  • Direct secure messaging: chelsea.mcintosh@chcict.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1003255274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 FRANKLIN ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069025113",
            "telephone_number": "203-969-0802",
            "fax_number": "203-316-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 FRANKLIN ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069025113",
            "telephone_number": "203-969-0802",
            "fax_number": "203-316-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "CHELSEA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301015521",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "3515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "BOSKA",
            "middle_name": "R",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.