Individual provider Active NPI

Laura J. Ginther Braun, PSY.D.

  • Clinical Psychologist
  • West Hartford, CT
National Provider Identifier
1083612972
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
001678 Issued in CT
Practice address
1007 Farmington Ave
Suite 15
West Hartford, CT 06107-2133
Phone
(860) 231-9189
Fax
(860) 233-2473
NPI assigned
Jul 13, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 001678 CT Primary
Clinical Child & Adolescent Psychologist 103TC2200X 001678 CT

Addresses

Primary practice location

1007 Farmington Ave
Suite 15
West Hartford, CT 06107-2133

Mailing address

45 Wood Cart LN
Haddam, CT 06438-1250
Phone (860) 231-9189

Other identifiers 1

IdentifierTypeStateIssuer
4109121MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051216000276 CT Practitioner - Clinical Psychologist 7315968492 Practice locations: West Hartford, CT
I20180402001701 NC Practitioner - Clinical Psychologist 7315968492 Practice locations: Wilmington, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

313 Walnut St
Suite 16
Wilmington, NC 28401-4063
Phone (860) 944-7629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5246NCMDSpeech-Language Pathologist
001678CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lauragintherbraun@tdh.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1083612972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WOOD CART LN",
            "city": "HADDAM",
            "state": "CT",
            "postal_code": "064381250",
            "telephone_number": "860-231-9189",
            "fax_number": "860-233-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 FARMINGTON AVE",
            "address_2": "SUITE 15",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072133",
            "telephone_number": "860-231-9189",
            "fax_number": "860-233-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINTHER BRAUN",
        "first_name": "LAURA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001678",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": "001678",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4109121",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.