Holly Hinderlie, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

003716 Issued in CT

Practice address

415 N Main St
Wallingford, CT 06492-3210

Phone

(202) 368-0193

NPI assigned

Feb 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1285266072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N MAIN ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N MAIN ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923210",
            "telephone_number": "202-368-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINDERLIE",
        "first_name": "HOLLY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CT",
            "license": "003716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Wallingford",
            "affiliation": "N",
            "address_1": "415 N Main St",
            "city": "Wallingford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064923210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Counseling Psychologist in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Counseling Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.