Active NPI
Colleen Keller Dreyfus, PH.D.
- Clinical Psychologist
- Hartford, CT
National Provider Identifier
1073671939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001802
- Practice address
- 191 Franklin Ave
Hartford, CT 06114-1386 - Phone
- (860) 571-3880
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001802 | CT | Primary |
Addresses
Primary practice location
191 Franklin Ave
Hartford, CT 06114-1386
Mailing address
122 D West Main Street
Stafford Springs, CT 06076
Phone (860) 684-2350
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 741694 | Other | MAGELLAN | |
| C009513 | Other | CHAMPUS | |
| 845341 | Other | FIRST HEALTH | |
| ZS284 | Other | OXFORD | |
| 060001802CT03 | Other | ANTHEM | |
| 080315 | Other | MHN | |
| 121201 | Other | COMPYSCH | |
| 6151571 | Other | UBH |
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 |
|---|---|---|---|
| 001802 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201651200000",
"number": "1073671939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 D WEST MAIN STREET",
"city": "STAFFORD SPRINGS",
"state": "CT",
"postal_code": "06076",
"telephone_number": "860-684-2350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 FRANKLIN AVE",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061141386",
"telephone_number": "860-571-3880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DREYFUS",
"first_name": "COLLEEN",
"middle_name": "KELLER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2008-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001802",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "741694",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "C009513",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "845341",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "ZS284",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "060001802CT03",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "080315",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPYSCH",
"identifier": "121201",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "6151571",
"state": null
}
],
"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 Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.