Individual provider Active NPI

Dena Rosenbloom, PH.D.

  • Clinical Psychologist
  • Glastonbury, CT
National Provider Identifier
1356497663
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1784 Issued in CT
Practice address
19 Concord St
Glastonbury, CT 06033-2135
Phone
(860) 657-3165
NPI assigned
Jan 27, 2007
Sex
Female
Sole proprietor
Yes

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 1784 CT Primary

Addresses

Primary practice location

19 Concord St
Glastonbury, CT 06033-2135

Mailing address

19 Concord St
Glastonbury, CT 06033-2135
Phone (860) 657-3165

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
I20171218000396 CT Practitioner - Clinical Psychologist 4981962198 Practice locations: West Hartford, CT

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1784CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen E. Garnet, PH.D., LLC Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356497663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CONCORD ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332135",
            "telephone_number": "860-657-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 CONCORD ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332135",
            "telephone_number": "860-657-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLOOM",
        "first_name": "DENA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "1784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.