Individual provider Active NPI

Ellen Deborah Nasper, PHD

  • Clinical Psychologist
  • Bridgeport, CT
National Provider Identifier
1356413215
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
CT001283 Issued in CT
Practice address
1635 Central Avenue
Southwest Connecticut Mental Health System
Bridgeport, CT 06610
Phone
(203) 551-7660
Fax
(203) 651-7481
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 CT001283 CT Primary

Addresses

Primary practice location

1635 Central Avenue
Southwest Connecticut Mental Health System
Bridgeport, CT 06610

Mailing address

1635 Central Avenue
Room 213 Southwest CT Mental Health System Attn Sandra
Bridgeport, CT 06610
Phone (203) 551-7660

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
I20120131000109 CT Practitioner - Clinical Psychologist 2466640032 Practice locations: New Haven, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7 Burns St
New Haven, CT 06511-1301
Phone (203) 624-1444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
CT001283CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut PastSince Jul 16, 1998 Accepting new patients
State of Connecticut Past Accepting new patients

Organizations & group practices 2

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356413215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVENUE",
            "address_2": "ROOM 213 SOUTHWEST CT MENTAL HEALTH SYSTEM ATTN SANDRA",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660",
            "fax_number": "203-651-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVENUE",
            "address_2": "SOUTHWEST CONNECTICUT MENTAL HEALTH SYSTEM",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660",
            "fax_number": "203-651-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASPER",
        "first_name": "ELLEN",
        "middle_name": "DEBORAH",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "CT001283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.