NPIMap

Organization Active NPI

Octave Behavioral PA

  • Psychologist
  • Hartford, CT
National Provider Identifier
1013645563
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
OCTAVE BEHAVIORAL PA
Practice address
225 Asylum St FL 20
Hartford, CT 06103-1532
Phone
(415) 360-3833
Fax
(628) 234-3048
NPI assigned
Aug 11, 2022
Organization subpart
Yes
Parent organization
OCTAVE BEHAVIORAL PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Kym Everett
Title
VP Revenue Operations
Phone
(650) 504-2289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

225 Asylum St FL 20
Hartford, CT 06103-1532

Mailing address

625 Market St
San Francisco, CA 94105-3302
Phone (650) 504-2289

Other practice location 1

284 Racebrook Rd Ste 200
Orange, CT 06477-3103
Phone (415) 360-3833

National Provider Directory

National Provider Directory
Tax ID family
Octave Behavioral PA11 organizations share this tax ID, including this one
Part of
Octave Behavioral PA

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1013645563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MARKET ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941053302",
            "telephone_number": "650-504-2289",
            "fax_number": "628-234-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 ASYLUM ST FL 20",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061031532",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "284 Racebrook Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CT",
            "postal_code": "064773103",
            "country_code": "US",
            "telephone_number": "415-360-3833",
            "fax_number": "628-234-3048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OCTAVE BEHAVIORAL PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OCTAVE BEHAVIORAL PA",
        "enumeration_date": "2022-08-11",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "KYM",
        "authorized_official_title_or_position": "VP REVENUE OPERATIONS",
        "authorized_official_telephone_number": "650-504-2289"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.