Kenneth P. Bangs, PH.D.

Individual provider Active NPI Clinical Psychologist · Plainville, CT

NPI 1508912205 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508912205
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
1523 (CT)
Practice address
91 Northwest Dr
Wheeler Clinic
Plainville, CT 06062-1534
Phone
(860) 793-3816
Fax
(860) 793-3591
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
001523CTMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1523 CT Yes

Addresses

Primary practice location

91 Northwest Dr
Wheeler Clinic
Plainville, CT 06062-1534

Mailing address

99 Dyer Ave
Collinsville, CT 06019-3233
Phone (860) 693-1880

Other providers in Plainville, CT

All providers in Plainville, CT · Clinical Psychologist in Connecticut

Sources for this page

Verify at the official NPI Registry.