Active NPI
Diane Marie Powell, PH. D.
- Clinical Psychologist
- Norwich, CT
National Provider Identifier
1215965843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001592CT
- Practice address
- 12 Case St
Suite 310
Norwich, CT 06360-2222 - Phone
- (860) 887-5361
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001592CT | CT | Primary |
Addresses
Primary practice location
12 Case St
Suite 310
Norwich, CT 06360-2222
Mailing address
291 N Burnham Hwy
Lisbon, CT 06351-2803
Phone (860) 376-0659
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150808015736 | CA | Practitioner - Clinical Psychologist | 2567776214 | Practice locations: Sacramento, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1969
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1329 Howe Ave
Sacramento, CA 95825-3363
Phone (916) 943-5434
488 Hartnell PL
Sacramento, CA 95825-6616
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1592 | CT | MD | Professional Counselor |
| 001592CT | CT | MD | Clinical Psychologist |
| 25430 | CA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215965843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "291 N BURNHAM HWY",
"city": "LISBON",
"state": "CT",
"postal_code": "063512803",
"telephone_number": "860-376-0659",
"fax_number": "860-376-6478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 CASE ST",
"address_2": "SUITE 310",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602222",
"telephone_number": "860-887-5361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "DIANE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PH. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001592CT",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.