Kelly Tahaney Weber, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

002358 Issued in CT

Practice address

300 Hebron Avenue
Suite 217 Medical Arts Center Counseling Affiliates
Glastonbury, CT 06033

Phone

(860) 659-2697

Fax

(860) 659-3468

NPI assigned

Nov 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Kelly Dale Tahaney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285705509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 N QUAKER LANE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06119",
            "telephone_number": "860-236-1695",
            "fax_number": "860-236-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEBRON AVENUE",
            "address_2": "SUITE 217 MEDICAL ARTS CENTER COUNSELING AFFILIATES",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "06033",
            "telephone_number": "860-659-2697",
            "fax_number": "860-659-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "KELLY",
        "middle_name": "TAHANEY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "002358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11518434",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "TAHANEY",
            "middle_name": "DALE",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alissa Watson, APRN
• WCG CT PLLC
• Mariusz Wdowiak, PTA
• Jennifer Anne Webb, D.V.M.
• Natalie C Webb, MD
• Shamichae D. Weidman, PHARMD
• Wellevate Counseling LLC
• Wellstone Counseling PLLC
• Mark Weremchuk, MD
• Neal Johnson Wetmore, L.O

• Psychologist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.