Individual provider Active NPI

Alison Sue Tane, PSYD

  • Clinical Psychologist
  • Westport, CT
National Provider Identifier
1285748327
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1166 Issued in CT
Practice address
10 Vineyard LN
Westport, CT 06880-2255
Phone
(203) 222-1927
Fax
(203) 226-4651
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 1166 CT Primary

Addresses

Primary practice location

10 Vineyard LN
Westport, CT 06880-2255

Mailing address

10 Vineyard LN
Westport, CT 06880-2255
Phone (203) 222-1927

Other identifiers 1

IdentifierTypeStateIssuer
004080503MedicaidCT

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
I20120215000001 CT Practitioner - Clinical Psychologist 7012184658 Practice locations: Westport, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Nova Southeastern Univ College of Dental Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10 Vineyard LN
Westport, CT 06880-2255
Phone (203) 222-1927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1166CTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1285748327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 VINEYARD LN",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068802255",
            "telephone_number": "203-222-1927",
            "fax_number": "203-226-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 VINEYARD LN",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068802255",
            "telephone_number": "203-222-1927",
            "fax_number": "203-226-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANE",
        "first_name": "ALISON",
        "middle_name": "SUE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "1166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004080503",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

Verify at the official NPI Registry.