Sandra E. Hartdagen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

001580 Issued in CT

Practice address

148 Eastern Blvd
Glastonbury, CT 06033-4321

Phone

(860) 652-3687

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 20, 2019 through Mar 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013037860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 OAK ST",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742342",
            "telephone_number": "860-648-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EASTERN BLVD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334321",
            "telephone_number": "860-652-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTDAGEN",
        "first_name": "SANDRA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jami C Harel, LMSW
• Harold E Beam
• Kenneth Wayne Harrington, M.ED., LPC
• Evan Wynne Harris, M.D.
• Nyja Lascia Jean Hart
• Kara Lynn Harte, LMFT
• Hartford Clinical Associates, PC
• Hartford County Cardiology PC
• Hartford Eye Physicians PC
• Hartford Healthcare Medical Group Specialists LLC

• Clinical Psychologist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.