Lukasz M Krol, PSY.D.
Individual provider Active NPI Clinical Psychologist · West Hatford, CT
NPI 1346512175 · NPPES record last updated Feb 9, 2012
Key facts
- NPI
- 1346512175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 3156 (CT)
- Practice address
- 68 South Main Street
Suite 100
West Hatford, CT 06107-2430 - Phone
- (860) 521-4899
- Fax
- (860) 521-4858
- NPI assigned
- Feb 9, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
745 Main St
East Hartford, CT 06108-3115
Phone (860) 289-2791
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120406000005 | CT | Practitioner - Clinical Psychologist | 9032370705 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Applied Behavioral Sciences LLC | Clinical | Current |
Accepting new patients |
| Peter Tolisano PSYD LLC | Past | Accepting new patients |
Locations
745 Main St
East Hartford, CT 06108
Phone (860) 289-2791
41 N Main St
West Hartfrd, CT 06107
Phone (860) 236-7333
68 S Main St
Bsmt 100
West Htfd, CT 06107
Phone (860) 236-7333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3156 | CT | Yes |
Addresses
Primary practice location
68 South Main Street
Suite 100
West Hatford, CT 06107-2430
Mailing address
275 Ridgewood Road
West Hartford, CT 06107-3542
Phone (860) 521-4899
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.