Clinical Bridge

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

001477 Issued in CT

Legal business name

CLINICAL BRIDGE

Practice address

209 Main St
Southington, CT 06489-2539

Phone

(203) 216-2036

NPI assigned

Sep 29, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan F. Michaelis, PH.D.

Title

President

Phone

(203) 216-2036

Specialties & licenses 2

Addresses

Tax ID family

Ams Solutions2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ams Solutions

  • Counselor
  • Newington, CT
  • NPI 1194861112
  NPD tax ID

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254182400000",
    "number": "1235463845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MAIN ST",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892539",
            "telephone_number": "203-216-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MAIN ST",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892539",
            "telephone_number": "203-216-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL BRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-29",
        "last_updated": "2009-09-29",
        "status": "A",
        "authorized_official_last_name": "MICHAELIS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-216-2036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "001477",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": "001477",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Manning MD LLC
• Anthony Dominick Ciardella, MD
• Linda Ciotto, OTA/L
• CJ's Counseling, LLC
• Cathleen Marie Clark, MPT
• Clufoir Counseling and Social Services LLC
• Clufoir Inc
• Robert Codio, MT-BC
• Elliott Ralph Colasanto, RPH
• Michael Colella, CRNA

• Clinical Neuropsychologist in Southington, CT
• Providers in Southington, CT by specialty
• Clinical Neuropsychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; 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.