Active NPI
Bennett Edward Moehl, PSYD
- Clinical Psychologist
- Plainville, CT
National Provider Identifier
1063674893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 003453
- Practice address
- 91 Northwest Dr
Plainville, CT 06062-1534 - Phone
- (860) 793-3500
- NPI assigned
- Jul 2, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 003453 | CT | Primary |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
91 Northwest Dr
Plainville, CT 06062-1534
Mailing address
371 Brewster Rd
Bristol, CT 06010
Phone (860) 906-7006
Other practice location 1
55 Hatchetts Hill Rd
Old Lyme, CT 06371-1534
Phone (800) 370-3651
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harvest Healthcare LLC | Current | Accepting new patients |
Locations
21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182
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 and National Provider Directory roles.
-
- Clinical Social Worker
- Avon, CT
- NPI 1477712917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1063674893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "371 BREWSTER RD",
"city": "BRISTOL",
"state": "CT",
"postal_code": "06010",
"telephone_number": "860-906-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 NORTHWEST DR",
"city": "PLAINVILLE",
"state": "CT",
"postal_code": "060621534",
"telephone_number": "860-793-3500"
}
],
"practiceLocations": [
{
"address_1": "55 Hatchetts Hill Rd",
"address_purpose": "LOCATION",
"city": "Old Lyme",
"state": "CT",
"postal_code": "063711534",
"country_code": "US",
"telephone_number": "800-370-3651",
"fax_number": "877-515-7147",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOEHL",
"first_name": "BENNETT",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-02",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "003453",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.