Larry Michael Bilker, PHD
Individual provider Active NPI Psychologist · Guilford, CT
NPI 1013943695 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013943695
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 000903 (CT)
- Practice address
- 296 Valley Shores Drive
Guilford, CT 06437-2147 - Phone
- (203) 453-4446
- NPI assigned
- Jun 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1970
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
296 Valley Shore Dr
Guilford, CT 06437-2147
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060814000177 | CT | Practitioner - Clinical Psychologist | 9436152709 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000903 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Larry Bilker, PH.D., LLC | Psychologist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 000903 | CT | Yes |
Addresses
Primary practice location
296 Valley Shores Drive
Guilford, CT 06437-2147
Mailing address
296 Valley Shores Drive
Guilford, CT 06437-2147
Phone (203) 453-0263
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0600000903CT01 | Other | CT | ANTHEM |
| P405018 | Other | CT | OXFORD |
Other names
- Larry Bilker
Other providers in Guilford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.