NPIMap

Organization Active NPI

Comprehensive Psychological & Assessment Services LLC

  • Clinical Psychologist
  • Wethersfield, CT
National Provider Identifier
1447545231
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
COMPREHENSIVE PSYCHOLOGICAL & ASSESSMENT SERVICES LLC
Practice address
55 Town Line Rd
Suite #101
Wethersfield, CT 06109-4352
Phone
(860) 757-3702
Fax
(860) 757-3725
NPI assigned
Jun 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Margarita Hernandez, P.H.D.NPI 1073775268
Title
Psychologist/Owner
Phone
(860) 757-3702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Psychoanalysis PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0814X
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

55 Town Line Rd
Suite #101
Wethersfield, CT 06109-4352

Mailing address

55 Town Line Rd
Suite #101
Wethersfield, CT 06109-4352
Phone (860) 757-3702

Other identifiers 1

IdentifierTypeStateIssuer
002171OtherCTLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120913000022 CT Part B Supplier - Clinic/Group Practice 5395993588 Receives reassigned benefits from 1 practitioner
Practice locations: Wethersfield, CT

National Provider Directory

National Provider Directory

Locations

55 Town Line Rd
Ste 101
Wethersfield, CT 06109
Phone (860) 757-3702

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1447545231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 TOWN LINE RD",
            "address_2": "SUITE #101",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094352",
            "telephone_number": "860-757-3702",
            "fax_number": "860-757-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 TOWN LINE RD",
            "address_2": "SUITE #101",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094352",
            "telephone_number": "860-757-3702",
            "fax_number": "860-757-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PSYCHOLOGICAL & ASSESSMENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-09",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "MARGARITA",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "860-757-3702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.H.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Psychoanalysis",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "002171",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.