Active NPI
Kathleen Carolyn Wawrzyniak Webb, PSY.D.
- Family Psychologist
- Avon, CT
National Provider Identifier
1497877575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Psychologist
- License
- 3003
- Practice address
- 34 Dale Rd
Suite 212
Avon, CT 06001-3659 - Phone
- (860) 878-2028
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3003 | CT | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 3003 | CT | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 3003 | CT | |
| Family Psychologist | 103TF0000X | 3003 | CT | Primary |
Addresses
Primary practice location
34 Dale Rd
Suite 212
Avon, CT 06001-3659
Mailing address
34 Dale Rd
Suite 212
Avon, CT 06001-3659
Phone (860) 878-2028
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CBHP005780 | Medicaid | CT |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3003 | CT | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388620800000",
"number": "1497877575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 DALE RD",
"address_2": "SUITE 212",
"city": "AVON",
"state": "CT",
"postal_code": "060013659",
"telephone_number": "860-878-2028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 DALE RD",
"address_2": "SUITE 212",
"city": "AVON",
"state": "CT",
"postal_code": "060013659",
"telephone_number": "860-878-2028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAWRZYNIAK WEBB",
"first_name": "KATHLEEN",
"middle_name": "CAROLYN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2014-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "3003",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CT",
"license": "3003",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CT",
"license": "3003",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "CT",
"license": "3003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CBHP005780",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.