Individual provider Active NPI

Eleanor A Hirtreiter, PH.D.

  • Clinical Psychologist
  • West Hartford, CT
National Provider Identifier
1154485456
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1620 Issued in CT
Practice address
68 S Main St
Suite 202
West Hartford, CT 06107-2445
Phone
(860) 521-7117
Fax
(860) 561-6184
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1620 CT Primary

Addresses

Primary practice location

68 S Main St
Suite 202
West Hartford, CT 06107-2445

Mailing address

68 S Main St
Suite 202
West Hartford, CT 06107-2445
Phone (860) 521-7117

Other identifiers 1

IdentifierTypeStateIssuer
060001620CT03OtherCTANTHEM BCBS ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000500 CT Practitioner - Clinical Psychologist 1850568288 Practice locations: Burlington, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
State University of New York at Buffalo School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16 Deerfield Trce
Burlington, CT 06013-1514
Phone (860) 306-4463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1620CTMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1154485456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 S MAIN ST",
            "address_2": "SUITE 202",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072445",
            "telephone_number": "860-521-7117",
            "fax_number": "860-561-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 S MAIN ST",
            "address_2": "SUITE 202",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072445",
            "telephone_number": "860-521-7117",
            "fax_number": "860-561-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRTREITER",
        "first_name": "ELEANOR",
        "middle_name": "A",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "1620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS ID",
            "identifier": "060001620CT03",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.