Active NPI
Christy Alexa Steimer Jackson, PH.D.
- Clinical Psychologist
- Enfield, CT
National Provider Identifier
1518232107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 002576
- Practice address
- 153 Hazard Ave
Enfield, CT 06082-4592 - Phone
- (860) 731-5522
- Fax
- (860) 731-5536
- NPI assigned
- Mar 14, 2012
- Last updated
- Oct 30, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 002576 | CT | Primary |
Addresses
Primary practice location
153 Hazard Ave
Enfield, CT 06082-4592
Mailing address
995 Day Hill Rd
Windsor, CT 06095-1722
Phone (860) 731-5522
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002576 | CT | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414627200000",
"number": "1518232107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "995 DAY HILL RD",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060951722",
"telephone_number": "860-731-5522",
"fax_number": "860-731-5536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 HAZARD AVE",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060824592",
"telephone_number": "860-731-5522",
"fax_number": "860-731-5536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CHRISTY",
"middle_name": "ALEXA STEIMER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-14",
"last_updated": "2014-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "002576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.