Active NPI
Sheila Renee Dupuis, PSY.D.
- Clinical Psychologist
- Glastonbury, CT
National Provider Identifier
1407077860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 002620
- Practice address
- 41C New London Tpke
Glastonbury, CT 06033-4206 - Phone
- (860) 659-0579
- Fax
- (860) 659-0570
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 002620 | CT | Primary |
Addresses
Primary practice location
41C New London Tpke
Glastonbury, CT 06033-4206
Mailing address
41C New London Tpke
Glastonbury, CT 06033-4206
Phone (860) 659-0579
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 357673 | Other | CT | MHN INS |
| 004250461 | Other | CT | EDS-CT BHP INS |
| 060002620CT01 | Other | CT | ANTHEM INS. |
| 61-28606 | Other | CT | UBH INS |
| P3671225 | Other | CT | OXFORD INS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002620 | CT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407077860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41C NEW LONDON TPKE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060334206",
"telephone_number": "860-659-0579",
"fax_number": "860-659-0570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41C NEW LONDON TPKE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060334206",
"telephone_number": "860-659-0579",
"fax_number": "860-659-0570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPUIS",
"first_name": "SHEILA",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "002620",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN INS",
"identifier": "357673",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDS-CT BHP INS",
"identifier": "004250461",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM INS.",
"identifier": "060002620CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH INS",
"identifier": "61-28606",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD INS",
"identifier": "P3671225",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.