Dorde Modrakovic, PHD.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5432 Issued in CT

Practice address

675 Main St
Middletown, CT 06457-2732

Phone

(860) 709-4232

Fax

(860) 343-7379

NPI assigned

Aug 27, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mir Modrakovic Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1265349880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 GRAND ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572705",
            "telephone_number": "860-347-6971",
            "fax_number": "860-343-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572732",
            "telephone_number": "860-709-4232",
            "fax_number": "860-343-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODRAKOVIC",
        "first_name": "DORDE",
        "credential": "PHD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "5432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIR",
            "last_name": "MODRAKOVIC",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Vania Modesto Lowe, M.D.
• Krupa Modi, APRN
• Viraj Devang Modi
• Ermal Molla, MD
• Amanda Marie Monfalcone, PA-C
• Japheth Ogamba Mongare, D.P.M
• Frank A Moore, MD, MBA
• Marlene Moore, RDH

• Clinical Psychologist in Middletown, CT
• Providers in Middletown, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.