Individual provider Active NPI

Paul Doolan, PSY.D.

  • Psychologist
  • New Haven, CT
National Provider Identifier
1083125165
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
003698 Issued in CT
Practice address
157 Church St FL 19
New Haven, CT 06510-2100
Phone
(203) 403-7380
NPI assigned
Oct 17, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 003698 CT Primary
Psychologist 103T00000X 024096 NY

Addresses

Primary practice location

157 Church St FL 19
New Haven, CT 06510-2100

Mailing address

157 Church St FL 19
New Haven, CT 06510-2100
Phone (203) 403-7380

Other practice location 1

1506 Post Road
Second Floor
Fairfield, CT 06824
Phone (203) 403-7380

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
003698CTMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1083125165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 CHURCH ST FL 19",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102100",
            "telephone_number": "203-403-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 CHURCH ST FL 19",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102100",
            "telephone_number": "203-403-7380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1506 Post Road",
            "address_2": "Second Floor",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CT",
            "postal_code": "06824",
            "country_code": "US",
            "telephone_number": "203-403-7380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOOLAN",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-17",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003698",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "024096",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.