Active NPI
Xoli Redmond, PSY.D.
- Psychologist
- New Haven, CT
National Provider Identifier
1437434917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3209
- Practice address
- 436 Orange St
New Haven, CT 06511-6402 - Phone
- (203) 772-8882
- NPI assigned
- Oct 17, 2011
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3209 | CT | Primary |
| Clinical Psychologist | 103TC0700X | 3209 | CT | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 3209 | CT | |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 3209 | CT | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 3209 | CT | |
| Family Psychologist | 103TF0000X | 3209 | CT |
Addresses
Primary practice location
436 Orange St
New Haven, CT 06511-6402
Mailing address
436 Orange St
New Haven, CT 06511-6402
Phone (203) 772-8882
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004235918 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 30, 2023 through Jun 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3209 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441324800000",
"number": "1437434917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "436 ORANGE ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065116402",
"telephone_number": "203-772-8882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "436 ORANGE ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065116402",
"telephone_number": "203-772-8882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDMOND",
"first_name": "XOLI",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-17",
"last_updated": "2015-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "3209",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "3209",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CT",
"license": "3209",
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "3209",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CT",
"license": "3209",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "CT",
"license": "3209",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004235918",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.