NPIMap

Organization Active NPI

Kathie H. Moffitt PHD

  • Clinical Psychologist
  • Glastonbury, CT
National Provider Identifier
1235580606
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2984 Issued in CT
Legal business name
KATHIE H. MOFFITT PHD
Practice address
148 Eastern Blvd Ste 306
Glastonbury, CT 06033-4321
Phone
(860) 970-7782
NPI assigned
Jun 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Authorized official

Name
Kathie H Moffitt, PHDNPI 1447579982
Title
Owner
Phone
(860) 970-7782

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 2984 CT Primary

Addresses

Primary practice location

148 Eastern Blvd Ste 306
Glastonbury, CT 06033-4321

Mailing address

PO Box 3028
Vernon, CT 06066-1928
Phone (860) 970-7782

National Provider Directory

National Provider Directory

Locations

300 Hebron Ave
Ste 201
Glastonbury, CT 06033
Phone (860) 338-4227

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1235580606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3028",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060661928",
            "telephone_number": "860-970-7782",
            "fax_number": "860-812-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EASTERN BLVD STE 306",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334321",
            "telephone_number": "860-970-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHIE H. MOFFITT PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "MOFFITT",
        "authorized_official_first_name": "KATHIE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-970-7782",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "2984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.