Active NPI
Ellen Deborah Nasper, PHD
- Clinical Psychologist
- Bridgeport, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- CT001283
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| CT001283 | CT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Connecticut | Past | 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.
-
dba Department of Veterans' Affairs, Veterans Home
- Skilled Nursing Facility
- Rocky Hill, CT
- NPI 1205951662
-
dba Southwest Connecticut Mental Health System
- Psychiatric Hospital
- Bridgeport, CT
- NPI 1720013360
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.