Dylan McBrien Kollman, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002921 Issued in CT

Practice address

224 Ridge Rd
Madison, CT 06443-2067

Phone

(617) 821-5481

NPI assigned

Dec 6, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/soundcommunityservices/r4/

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

• Sound Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1396700886
  NPD (past)
• Urologic Associates, PC

  • Urology Physician
  • New London, CT
  • NPI 1740362730
  NPD (past)

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1316120835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 RIDGE RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432067",
            "telephone_number": "617-821-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 RIDGE RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432067",
            "telephone_number": "617-821-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLMAN",
        "first_name": "DYLAN",
        "middle_name": "MCBRIEN",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-06",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kornelia Keszler, MD
• Julia King, PSY.D., MBA
• Marilyn Kirk, NBC-HWC
• Alyssa Kizilski
• Alexander Klein
• Nina Melanie Korman, LMFT
• Kornelia Keszler, MD, PC
• Lori Kostich, SLP
• Marissa Kottage
• Ann Melinda Kraft, MSN APRN PMHNP

• Clinical Psychologist in Madison, CT
• Providers in Madison, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.