Individual provider Active NPI

Michelle B Mirsky, PSYD

  • Clinical Psychologist
  • Hartford, CT
National Provider Identifier
1396168464
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
003414 Issued in CT
Practice address
200 Retreat Ave
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309
Phone
(860) 545-7940
NPI assigned
Jan 27, 2014
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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 003414 CT Primary

Addresses

Primary practice location

200 Retreat Ave
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309

Mailing address

200 Retreat Ave
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-3309
Phone (860) 545-7940

Other identifiers 1

IdentifierTypeStateIssuer
003414OtherCTSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150422000063 CT Practitioner - Clinical Psychologist 7810215985 Reassigns benefits to 6 organizations
I20230803002094 VA Practitioner - Clinical Psychologist 7810215985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Assessment and Therapy AssociatesGroup PAC ID 2062581481, 21 clinicians

Practice addresses (Care Compare)

1545 Crossways Blvd
Suite 250
Chesapeake, VA 23320-0218
Phone (757) 206-2772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3414CTMDProfessional Counselor
003414CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince May 12, 2022 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jun 1, 2019 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Aug 27, 2014 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Current Accepting new patients
Hartford Pathology Associates, P.C. Current Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Hartford Hospital CurrentSince Apr 3, 2017 Accepting new patients
Connecticut Pathology Group PC Current Accepting new patients
Middlesex Hospital Clinical CurrentSince Mar 1, 2023 Accepting new patients
Middlesex Hospital CurrentSince May 12, 2022 Accepting new patients
Hartford Hospital CurrentSince Apr 3, 2017 Accepting new patients
Hartford Hospital CurrentSince Apr 3, 2017 Accepting new patients
Assessment & Therapy Associates PC Clinical CurrentSince Jul 25, 2023 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Aug 27, 2014 Accepting new patients

Locations

100 Hazard Ave
Ste 206
Enfield, CT 06082
Phone (860) 749-1985

200 Retreat Ave
Hartford, CT 06106
Phone (860) 545-7000

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1545 Crossways Blvd
Chesapeake, VA 23320
Phone (757) 309-1405

1545 Crossways Blvd
Ste 25
Chesapeake, VA 23320
Phone (757) 206-2772

1545 Crossways Blvd
Ste 250
Chesapeake, VA 23320
Phone (757) 206-2772

Interoperability endpoints

  • Direct secure messaging: michelleb.mirsky@xdr.hhchealthdirect.org

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1396168464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRSKY",
        "first_name": "MICHELLE",
        "middle_name": "B",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "003414",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.