Individual provider Active NPI

Rachel Carlson, PSYD

  • Clinical Psychologist
  • West Hartford, CT
National Provider Identifier
1033600226
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
003990 Issued in CT
Practice address
17 S Highland St
West Hartford, CT 06119-1826
Phone
(860) 258-4171
NPI assigned
May 23, 2018
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X 003990 CT Primary

Addresses

Primary practice location

17 S Highland St
West Hartford, CT 06119-1826

Mailing address

17 S Highland St
West Hartford, CT 06119-1826
Phone (860) 258-4171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230824002884 CT Practitioner - Clinical Psychologist 9739542622 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003990CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Reflections LLC Mental Health CurrentSince Jul 23, 2023 Accepting new patients

Locations

17 S Highland St
West Hartford, CT 06119
Phone (860) 236-6009

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1033600226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 S HIGHLAND ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191826",
            "telephone_number": "860-258-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S HIGHLAND ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191826",
            "telephone_number": "860-258-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "RACHEL",
        "name_prefix": "Mrs.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.