Individual provider Active NPI

Candice L Weigle-Spier, PSYD

  • Psychologist
  • Middletown, CT
National Provider Identifier
1245213487
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
002044 Issued in CT
Practice address
770 Saybrook Rd
Building B
Middletown, CT 06457-4739
Phone
(860) 349-0385
Fax
(860) 343-5391
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 002044 CT Primary
Clinical Psychologist 103TC0700X 002044 CT

Addresses

Primary practice location

770 Saybrook Rd
Building B
Middletown, CT 06457-4739

Mailing address

770 Saybrook Rd
Building B
Middletown, CT 06457-4739
Phone (860) 349-0385

Other identifiers 1

IdentifierTypeStateIssuer
004167450MedicaidCT

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
I20040707000802 CT Practitioner - Clinical Psychologist 2860479821 Practice locations: Durham, CT; Middletown, CT; Old Saybrook, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21 Clark St
Old Saybrook, CT 06475-1402
Phone (860) 349-0385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002044CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Valalik Pmhnp BC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1245213487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 SAYBROOK RD",
            "address_2": "BUILDING B",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574739",
            "telephone_number": "860-349-0385",
            "fax_number": "860-343-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 SAYBROOK RD",
            "address_2": "BUILDING B",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574739",
            "telephone_number": "860-349-0385",
            "fax_number": "860-343-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIGLE-SPIER",
        "first_name": "CANDICE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "002044",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002044",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004167450",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.