Active NPI
Stephanie Bozak, PSY.D
- Clinical Psychologist
- Hartford, CT
National Provider Identifier
1518154038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3927
- Practice address
- 505 Hudson Street
8TH Floor
Hartford, CT 06106 - Phone
- (860) 936-1256
- NPI assigned
- Sep 28, 2007
- Last updated
- Apr 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3927 | CT | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Family Psychologist | 103TF0000X | |||
| Forensic Psychologist | 103TF0200X | |||
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | |||
| School Psychologist | 103TS0200X |
Addresses
Primary practice location
505 Hudson Street
8TH Floor
Hartford, CT 06106
Mailing address
50 Old Meadow Plain Rd
Simsbury, CT 06070-2733
Phone (860) 819-3093
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650931200000",
"number": "1518154038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 OLD MEADOW PLAIN RD",
"city": "SIMSBURY",
"state": "CT",
"postal_code": "060702733",
"telephone_number": "860-819-3093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 HUDSON STREET",
"address_2": "8TH FLOOR",
"city": "HARTFORD",
"state": "CT",
"postal_code": "06106",
"telephone_number": "860-936-1256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOZAK",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-28",
"last_updated": "2022-04-26",
"certification_date": "2022-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "3927",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.