NPIMap

Individual provider Active NPI

Diane C Wilson, PH.D.

  • Clinical Psychologist
  • Farmington, CT
National Provider Identifier
1497314264
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
003371 Issued in CT
Practice address
270 Farmington Ave Ste 328
Farmington, CT 06032-1909
Phone
(866) 887-6864
NPI assigned
Jun 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 003371 CT Primary

Addresses

Primary practice location

270 Farmington Ave Ste 328
Farmington, CT 06032-1909

Mailing address

263 Farmington Ave
Farmington, CT 06030-1410
Phone (860) 679-6700

Other practice location 1

263 Farmington Avenue
Farmington, CT 06030
Phone (860) 679-6700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwilson91687@direct.med.uchc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191122000792 CT Practitioner - Clinical Psychologist 4880026293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Connecticut 267 clinicians

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
003371CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Sep 1, 2025 Accepting new patients
State of Connecticut CurrentSince Sep 1, 2025 Accepting new patients
Advanced Treatment Solutions LLC Clinical CurrentSince Oct 6, 2019 Accepting new patients

Locations

270 Farmington Ave
Ste 328
Farmington, CT 06032
Phone (440) 537-3968

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

Interoperability endpoints

  • Direct secure messaging: dwilson91687@direct.med.uchc.edu

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1497314264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301410",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 FARMINGTON AVE STE 328",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321909",
            "telephone_number": "866-887-6864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Avenue",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "06030",
            "country_code": "US",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DIANE",
        "middle_name": "C",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwilson91687@direct.med.uchc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.