Individual provider Active NPI

Robert Martin Koenig, PH.D.

  • Clinical Psychologist
  • Hamden, CT
National Provider Identifier
1528078441
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
813 Issued in CT
Practice address
295 Washington Avenue
Suite 9
Hamden, CT 06518-3025
Phone
(203) 287-8227
Fax
(203) 287-9502
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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 813 CT Primary

Addresses

Primary practice location

295 Washington Avenue
Suite 9
Hamden, CT 06518-3025

Mailing address

295 Washington Avenue
Suite 9
Hamden, CT 06518-3025
Phone (203) 287-8227

Other identifiers 1

IdentifierTypeStateIssuer
060000813CT01OtherANTHEM BCBS

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
I20120319000252 CT Practitioner - Clinical Psychologist 7810992898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Laurel Health Services LLCGroup PAC ID 4284639261, 3 clinicians

Practice addresses (Care Compare)

295 Washington Ave
Suite 9
Hamden, CT 06518-3025
Phone (203) 287-8227

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
813CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Counseling and Addiction Services LLC CurrentSince Apr 28, 2024 Accepting new patients

Locations

295 Washington Ave
Ste 9
Hamden, CT 06518
Phone (203) 287-8227

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1528078441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 WASHINGTON AVENUE",
            "address_2": "SUITE 9",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183025",
            "telephone_number": "203-287-8227",
            "fax_number": "203-287-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 WASHINGTON AVENUE",
            "address_2": "SUITE 9",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183025",
            "telephone_number": "203-287-8227",
            "fax_number": "203-287-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "ROBERT",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "060000813CT01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.