Active NPI
Jonas F Katkavich, M.ED. PSY.D.
- Clinical Psychologist
- Farmington, CT
National Provider Identifier
1487956272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 002918
- Practice address
- 318 Main St
2ND Floor
Farmington, CT 06032-2961 - Phone
- (508) 740-6230
- NPI assigned
- Nov 30, 2010
- Sex
- Male
- 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 | 002918 | CT | Primary |
Addresses
Primary practice location
318 Main St
2ND Floor
Farmington, CT 06032-2961
Mailing address
318 Main St
2ND Floor
Farmington, CT 06032-2961
Phone (508) 740-6230
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002918 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291075200000",
"number": "1487956272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 MAIN ST",
"address_2": "2ND FLOOR",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060322961",
"telephone_number": "508-740-6230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 MAIN ST",
"address_2": "2ND FLOOR",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060322961",
"telephone_number": "508-740-6230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATKAVICH",
"first_name": "JONAS",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "M.ED. PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-30",
"last_updated": "2010-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "002918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.