Organization Active NPI

Michelle M Nitto, Psy.D. LLC

  • Clinical Psychologist
  • Rocky Hill, CT
National Provider Identifier
1023154689
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
002454 Issued in CT
Legal business name
MICHELLE M NITTO, PSY.D. LLC
Practice address
750 Old Main St
Suite 306
Rocky Hill, CT 06067-1567
Phone
(860) 524-7538
NPI assigned
Jan 30, 2007
Last updated
Dec 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Authorized official

Name
Dr. Michelle Nitto Leveille, PSY. D.NPI 1184604381
Title
Managing Member
Phone
(860) 524-7538

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 002454 CT Primary

Addresses

Primary practice location

750 Old Main St
Suite 306
Rocky Hill, CT 06067-1567

Mailing address

97 Whittlesey Rd
Woodbury, CT 06798-2535
Phone (203) 510-1494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060207000243 CT Part B Supplier - Clinic/Group Practice 8426063843 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbury, CT

National Provider Directory

National Provider Directory

Locations

385 Main St S
Ste 106
Southbury, CT 06488
Phone (203) 262-4600

43 Sherman Hill Rd
Ste D204
Woodbury, CT 06798
Phone (860) 524-7538

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1023154689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 WHITTLESEY RD",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067982535",
            "telephone_number": "203-510-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 OLD MAIN ST",
            "address_2": "SUITE 306",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671567",
            "telephone_number": "860-524-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE M NITTO, PSY.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "LEVEILLE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "NITTO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "860-524-7538",
        "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": "002454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.