Individual provider Active NPI

Jill M Donelan, PSY.D.

  • Clinical Psychologist
  • Hartford, CT
National Provider Identifier
1508134875
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10049-PY-PR Issued in MA
Practice address
331 Wethersfield Ave
The Village for Families and Children
Hartford, CT 06114
Phone
(860) 236-4511
Fax
(860) 231-8449
NPI assigned
Dec 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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 10049-PY-PR MA Primary

Addresses

Primary practice location

331 Wethersfield Ave
The Village for Families and Children
Hartford, CT 06114

Mailing address

150 Lower Westfield Rd
Holyoke, MA 01040-2890
Phone (413) 322-4984

Other names 1

  • Dr. Jill M Donelan Professional name

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

LicenseStateTypeSpecialty
10049-PY-PRMAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1508134875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LOWER WESTFIELD RD",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010402890",
            "telephone_number": "413-322-4984",
            "fax_number": "133-224-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 WETHERSFIELD AVE",
            "address_2": "THE VILLAGE FOR FAMILIES AND CHILDREN",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06114",
            "telephone_number": "860-236-4511",
            "fax_number": "860-231-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONELAN",
        "first_name": "JILL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-01",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10049-PY-PR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "DONELAN",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; 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.