Diane Brackett, PHD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

000359 Issued in CT

Practice address

354 Hartford Tpke
Hampton, CT 06247-1320

Phone

(860) 455-1404

Fax

(860) 455-1396

NPI assigned

Jan 25, 2007

Last updated

Nov 17, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New England Center for Hearing Rehabilitation LLCGroup PAC ID 2062710478, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New England Center for Hearing Rehabilitation LLC

  • Audiologist-Hearing Aid Fitter
  • Mansfield Center, CT
  • NPI 1679932925

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• New England Center for Hearing

  • Early Intervention Provider Agency
  • Hampton, CT
  • NPI 1720401664
  Authorized official Same address or phone

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1285780379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 POND HILL RD",
            "city": "MOOSUP",
            "state": "CT",
            "postal_code": "063541836",
            "telephone_number": "860-564-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 HARTFORD TPKE",
            "city": "HAMPTON",
            "state": "CT",
            "postal_code": "062471320",
            "telephone_number": "860-455-1404",
            "fax_number": "860-455-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "000359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliana Bar-Shalom
• Eastconn
• Benjamin Edwards
• Tara Lynn Falck, MSOTR/L
• Family Resource Services LLC
• Julia Garrick, AUD

• Speech-Language Pathologist in Hampton, CT
• Providers in Hampton, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.