Active NPI
Joseph A Cherepon, PHD
- Clinical Psychologist
- Avon, CT
National Provider Identifier
1366928053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001216
- Practice address
- 21 Waterville Rd
Avon, CT 06001-2097 - Phone
- (860) 284-0182
- NPI assigned
- Jul 16, 2018
- Last updated
- Jul 16, 2018
- Sex
- Male
- 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 | 001216 | CT | Primary |
Addresses
Primary practice location
21 Waterville Rd
Avon, CT 06001-2097
Mailing address
21 Waterville Rd
Avon, CT 06001-2097
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001216 | CT | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531699200000",
"number": "1366928053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 WATERVILLE RD",
"city": "AVON",
"state": "CT",
"postal_code": "060012097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 WATERVILLE RD",
"city": "AVON",
"state": "CT",
"postal_code": "060012097",
"telephone_number": "860-284-0182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEREPON",
"first_name": "JOSEPH",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-16",
"last_updated": "2018-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.