Individual provider Active NPI

Lowell H Kallen, M.D.

  • Child & Adolescent Psychiatry Physician
  • Danielson, CT
National Provider Identifier
1528053949
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
29573 Issued in CT
Practice address
245 Main St
Danielson, CT 06239-2816
Phone
(888) 316-5221
Fax
(866) 203-2138
NPI assigned
Sep 12, 2005
Last updated
Jan 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 029573 CT
Psychiatry Physician 2084P0800X 0101234443 VA
Psychiatry Physician 2084P0800X 29573 CT
Child & Adolescent Psychiatry Physician 2084P0804X 0101234443 VA
Child & Adolescent Psychiatry Physician 2084P0804X 29573 CT Primary

Addresses

Primary practice location

245 Main St
Danielson, CT 06239-2816

Mailing address

245 Main St
Danielson, CT 06239-2816
Phone (757) 371-6772

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150427001946 CT Practitioner - Psychiatry 5193799682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Johns Hopkins University School of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regeneration Therapy and Counseling LLCGroup PAC ID 7719363886, 8 clinicians

Practice addresses (Care Compare)

245 Main St
Danielson, CT 06239-2816
Phone (888) 316-5221

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029573CTMDPsychiatry Physician
29573CTMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regeneration Therapy and Counseling LLC CurrentSince Jul 19, 2024 Accepting new patients
Perception Programs Inc CurrentSince Jun 1, 2020 Accepting new patients
Comprehensive Psychological Services Psychiatry PastSince Apr 1, 2023 Accepting new patients
Western Tidewater Community Mental Psychiatry PastSince May 4, 2012 Accepting new patients
Churchland Psychiatric Associates PC Psychiatry PastSince Jul 1, 1990 Accepting new patients
Riverside Physician Services Inc Psychiatry Past Accepting new patients

Locations

245 Main St
Danielson, CT 06239
Phone (401) 935-3824

842 Main St
Willimantic, CT 06226
Phone (860) 450-0151

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/perceptionprograms/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1528053949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MAIN ST",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062392816",
            "telephone_number": "757-371-6772",
            "fax_number": "866-203-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MAIN ST",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062392816",
            "telephone_number": "888-316-5221",
            "fax_number": "866-203-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLEN",
        "first_name": "LOWELL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "029573",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101234443",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "29573",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101234443",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "29573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danielson, CT

Sources for this page

Verify at the official NPI Registry.