Individual provider Active NPI

Kathleen Mary Croce, PH D

  • Clinical Psychologist
  • Guilford, CT
National Provider Identifier
1508845439
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
001145 Issued in CT
Practice address
103 Schoolside LN
Guilford, CT 06437-4806
Phone
(203) 458-2075
Fax
(203) 458-2075
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 001145 CT Primary

Addresses

Primary practice location

103 Schoolside LN
Guilford, CT 06437-4806

Mailing address

103 Schoolside LN
Guilford, CT 06437-4806
Phone (203) 458-2075

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
I20090619000545 CT Practitioner - Clinical Psychologist 2567527302 Practice locations: Guilford, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

103 Schoolside LN
Guilford, CT 06437-4806
Phone (203) 458-2075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001145CTMDMarriage & Family Therapist
1145CTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508845439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SCHOOLSIDE LN",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064374806",
            "telephone_number": "203-458-2075",
            "fax_number": "203-458-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SCHOOLSIDE LN",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064374806",
            "telephone_number": "203-458-2075",
            "fax_number": "203-458-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCE",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

Verify at the official NPI Registry.