Individual provider Active NPI

Deborah Manzano, PSY. D.

  • Clinical Psychologist
  • Hebron, CT
National Provider Identifier
1295895332
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3470 Issued in CT
Practice address
121 East St
Hebron, CT 06248-1346
Phone
(860) 266-7759
Fax
(860) 797-2430
NPI assigned
Dec 11, 2006
Last updated
Sep 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 3470 CT Primary
Clinical Psychologist 103TC0700X 8301 MA

Addresses

Primary practice location

121 East St
Hebron, CT 06248-1346

Mailing address

121 East St
Hebron, CT 06248-1346
Phone (860) 266-7759

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
I20160321001177 CT Practitioner - Clinical Psychologist 9234152208 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

121 E St
Hebron, CT 06248-1346
Phone (860) 266-7759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3470CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Feb 15, 2021 Accepting new patients
Community Health Resources, Inc. Single Specialty CurrentSince Aug 1, 2017 Accepting new patients
Within Your Sight, LLC Clinical CurrentSince Dec 4, 2024 Accepting new patients
Middlesex Hospital Clinical Current Accepting new patients
Middlesex Hospital Single Specialty CurrentSince Feb 15, 2021 Accepting new patients
Charter Oak Health Center, Inc. CurrentSince Feb 1, 2016 Accepting new patients
Middlesex Hospital Single Specialty Current Accepting new patients
Charter Oak Health Center, Inc. Single Specialty CurrentSince Feb 1, 2016 Accepting new patients
Brightside Inc Single Specialty PastSince Feb 2, 2025 Accepting new patients

Locations

153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020

21 Grand St
Hartford, CT 06106

444 Center St
Manchester, CT 06040
Phone (860) 646-3888

103 S Main St
Middletown, CT 06457
Phone (860) 358-8760

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

2 Waterside Xing
Ste 401
Windsor, CT 06095

995 Day Hill Rd
Windsor, CT 06095
Phone (860) 697-3351

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1295895332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 EAST ST",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481346",
            "telephone_number": "860-266-7759",
            "fax_number": "860-797-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 EAST ST",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481346",
            "telephone_number": "860-266-7759",
            "fax_number": "860-797-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "3470",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8301",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hebron, CT

Sources for this page

Verify at the official NPI Registry.