Active NPI
Danielle Gayle Koby, PHD
- Clinical Psychologist
- Hartford, CT
National Provider Identifier
1033368675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 003149
- Practice address
- 200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3310 - Phone
- (860) 545-7940
- NPI assigned
- Sep 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS01181 | RI | |
| Clinical Psychologist | 103TC0700X | PS01181 | RI | |
| Clinical Psychologist | 103TC0700X | 003149 | CT | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
200 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3310
Mailing address
P.O. Box 415933
Hartford Hospital Professional Services
Boston, MA 02241-5933
Phone (860) 545-7602
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008031494 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS01181 | RI | MD | Clinical Psychologist |
| 003149 | CT | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1033368675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 415933",
"address_2": "HARTFORD HOSPITAL PROFESSIONAL SERVICES",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415933",
"telephone_number": "860-545-7602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 RETREAT AVENUE",
"address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061063310",
"telephone_number": "860-545-7940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOBY",
"first_name": "DANIELLE",
"middle_name": "GAYLE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-18",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "RI",
"license": "PS01181",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS01181",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "003149",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008031494",
"state": "CT"
}
],
"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 Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.