Individual provider Active NPI

Lori Grazia Diblasi, PSYD

  • Clinical Psychologist
  • West Hartford, CT
National Provider Identifier
1497545180
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
005005 Issued in CT
Practice address
15 N Main St Ste 1
West Hartford, CT 06107-1974
Phone
(860) 519-5227
Fax
(860) 955-3036
NPI assigned
May 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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 005005 CT Primary

Addresses

Primary practice location

15 N Main St Ste 1
West Hartford, CT 06107-1974

Mailing address

60 Euclid Ave
Stratford, CT 06614-1977
Phone (203) 212-1885

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021001067 CT Practitioner - Clinical Psychologist 7113433996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin D. Oliveira Psy D LLCGroup PAC ID 4385931195, 5 clinicians

Practice addresses (Care Compare)

15 N Main St
West Hartford, CT 06107-1974
Phone (860) 519-5227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005005CTMDAdult Health Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1497545180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 EUCLID AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141977",
            "telephone_number": "203-212-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N MAIN ST STE 1",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071974",
            "telephone_number": "860-519-5227",
            "fax_number": "860-955-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBLASI",
        "first_name": "LORI",
        "middle_name": "GRAZIA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "005005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.