Individual provider Active NPI

Krista Mancarella, PSY.D.

  • Clinical Psychologist
  • Glastonbury, CT
National Provider Identifier
1457601155
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3732 Issued in CT
Practice address
140 Chestnut Hill Rd
Glastonbury, CT 06033-4149
Phone
(267) 973-7891
NPI assigned
Sep 11, 2012
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS0017749 PA
Clinical Psychologist 103TC0700X 3732 CT Primary

Addresses

Primary practice location

140 Chestnut Hill Rd
Glastonbury, CT 06033-4149

Mailing address

140 Chestnut Hill Rd
Glastonbury, CT 06033-4149
Phone (267) 973-7891

Other practice location 1

846 W Lancaster Ave
Bryn Mawr, PA 19010-3224
Phone (860) 431-0622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS0017749PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Krista Mancarella LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1457601155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 CHESTNUT HILL RD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334149",
            "telephone_number": "267-973-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 CHESTNUT HILL RD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334149",
            "telephone_number": "267-973-7891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "846 W Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Bryn Mawr",
            "state": "PA",
            "postal_code": "190103224",
            "country_code": "US",
            "telephone_number": "860-431-0622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCARELLA",
        "first_name": "KRISTA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS0017749",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "3732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.