Scuddy Fontenelle IV

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3574 Issued in CT

Practice address

40 Temple St Ste 7D
New Haven, CT 06510-2715

Phone

(203) 785-6115

NPI assigned

Aug 26, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1124428313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 TEMPLE ST STE 7D",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102715",
            "telephone_number": "203-785-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 TEMPLE ST STE 7D",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102715",
            "telephone_number": "203-785-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENELLE",
        "first_name": "SCUDDY",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "3574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026265E",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Finbar T Foley, M.D., MPH
• Gillian Foley
• Michelle Ann Foley, DO
• Michael Wang Keong Fong, BSC, MBBS, FRACP
• Aliah Lucyanne Fonteh, MD
• Joanne Foodim, MD
• Rasadokht Forati, MD
• Forbes Psychotherapy Practice, LLC
• Rachel Forbes, LCSW
• Nicholas Forcello, PHARMD

• Clinical Psychologist in New Haven, CT
• Providers in New Haven, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.