Active NPI
Carol A. Kravitz, APRN
- Child & Adolescent Psychiatric/Mental Health Registered Nurse
- Derby, CT
National Provider Identifier
1427203124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatric/Mental Health Registered Nurse
- License
- 000829
- Practice address
- 30 Elizabeth St
Third Floor
Derby, CT 06418-1802 - Phone
- (203) 954-0543
- Fax
- (203) 954-0544
- NPI assigned
- Nov 21, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | 000829 | CT | Primary |
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | R48163 | CT |
Addresses
Primary practice location
30 Elizabeth St
Third Floor
Derby, CT 06418-1802
Mailing address
30 Elizabeth St
Third Floor
Derby, CT 06418-1802
Phone (203) 954-0543
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 |
|---|---|---|---|
| R48163 | CT | MD | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lower Naugatuck Valley Parent Child Resource Center, Inc. | 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.
-
- Mental Health Counselor
- Derby, CT
- NPI 1285610584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227225600000",
"number": "1427203124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 ELIZABETH ST",
"address_2": "THIRD FLOOR",
"city": "DERBY",
"state": "CT",
"postal_code": "064181802",
"telephone_number": "203-954-0543",
"fax_number": "203-954-0544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 ELIZABETH ST",
"address_2": "THIRD FLOOR",
"city": "DERBY",
"state": "CT",
"postal_code": "064181802",
"telephone_number": "203-954-0543",
"fax_number": "203-954-0544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAVITZ",
"first_name": "CAROL",
"middle_name": "A.",
"name_prefix": "Ms.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-21",
"last_updated": "2008-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0807X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
"state": "CT",
"license": "000829",
"primary": true
},
{
"code": "163WP0807X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
"state": "CT",
"license": "R48163",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Derby, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.