Individual provider Active NPI

Shirley Oribio Staltaro, PSY.D.

  • Clinical Psychologist
  • Rocky Hill, CT
National Provider Identifier
1275656266
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2883 Issued in CT
Practice address
2 Church St
Rocky Hill, CT 06067-1518
Phone
(860) 502-4908
Fax
(860) 513-4828
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2883 CT Primary

Addresses

Primary practice location

2 Church St
Rocky Hill, CT 06067-1518

Mailing address

2 Church St
Rocky Hill, CT 06067-1518
Phone (860) 502-4908

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
I20120531000288 CT Practitioner - Clinical Psychologist 9931130044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Rocky Hill, CT 06067
Phone (860) 502-4908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2883CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Staltaro Psychological Services LLC Clinical CurrentSince May 29, 2012 Accepting new patients
County of Madera Past Accepting new patients

Locations

96 Connecticut Blvd
East Hartford, CT 06108
Phone (860) 502-4908

Organizations & group practices 2

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1275656266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671518",
            "telephone_number": "860-502-4908",
            "fax_number": "860-513-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671518",
            "telephone_number": "860-502-4908",
            "fax_number": "860-513-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALTARO",
        "first_name": "SHIRLEY",
        "middle_name": "ORIBIO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "2883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

Verify at the official NPI Registry.