Edith Petrello Heath, PH.D.
Individual provider Active NPI Clinical Psychologist · Norfolk, CT
NPI 1275629099 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1275629099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 738 (CT)
- Practice address
- 400 North Street
Norfolk, CT 06058-0562 - Phone
- (860) 542-6941
- Fax
- (860) 542-5096
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000738 | CT | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 738 | CT | Yes |
Addresses
Primary practice location
400 North Street
Norfolk, CT 06058-0562
Mailing address
400 North Street
PO Box 562
Norfolk, CT 06058-0562
Phone (860) 542-6941
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 307568 | Other | CT | MHN |
| 060000738CT02 | Other | CT | ANTHEM |
Other providers in Norfolk, CT
- Paul A Gibilisco
- Heller Counseling Services LLC
- Sara Heller
- Edie Hochberg Hofstatter
- Eric Walter Johnson
- Joshua Lawrence
All providers in Norfolk, CT · Clinical Psychologist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.