Individual provider Active NPI

Michele Krynski, PHD

  • Clinical Psychologist
  • Bloomfield, CT
National Provider Identifier
1508078825
Registry record updated Nov 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
002349 Issued in CT
Practice address
1 Regency Drive
#101
Bloomfield, CT 06002
Phone
(860) 243-9301
Fax
(860) 298-0888
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2007

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 002349 CT Primary

Addresses

Primary practice location

1 Regency Drive
#101
Bloomfield, CT 06002

Mailing address

1 Regency Drive
#101
Bloomfield, CT 06002
Phone (860) 243-9301

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
002349CTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1508078825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 REGENCY DRIVE",
            "address_2": "#101",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "06002",
            "telephone_number": "860-243-9301",
            "fax_number": "860-298-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 REGENCY DRIVE",
            "address_2": "#101",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "06002",
            "telephone_number": "860-243-9301",
            "fax_number": "860-298-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYNSKI",
        "first_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.