Individual provider Active NPI

Katharine Bernstein, PHD

  • Counselor
  • Madison, CT
National Provider Identifier
1124427802
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
17A Woodland Rd
Madison, CT 06443-2342
Phone
(203) 779-5490
Fax
(203) 896-9830
NPI assigned
Aug 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

17A Woodland Rd
Madison, CT 06443-2342

Mailing address

17A Woodland Rd
Madison, CT 06443-2342
Phone (203) 779-5490

Other practice location 1

1680 Albany Ave
Hartford, CT 06105-1001
Phone (860) 236-4511

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
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Psychological CurrentSince Dec 1, 2019 Accepting new patients

Locations

17A Woodland Rd
Madison, CT 06443
Phone (203) 779-5490

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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1124427802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17A WOODLAND RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432342",
            "telephone_number": "203-779-5490",
            "fax_number": "203-896-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17A WOODLAND RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432342",
            "telephone_number": "203-779-5490",
            "fax_number": "203-896-9830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1680 Albany Ave",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051001",
            "country_code": "US",
            "telephone_number": "860-236-4511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "KATHARINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-19",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.