Active NPI
Tina Michelle Newman, PHD
- Clinical Child & Adolescent Psychologist
- Glastonbury, CT
National Provider Identifier
1528226537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 002613
- Practice address
- 2300 Main Street
CCSN
Glastonbury, CT 06033 - Phone
- (860) 430-1762
- Fax
- (860) 430-2648
- NPI assigned
- May 27, 2008
- 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 Child & Adolescent Psychologist | 103TC2200X | 002613 | CT | Primary |
Addresses
Primary practice location
2300 Main Street
CCSN
Glastonbury, CT 06033
Mailing address
2300 Main Street
CCSN
Glastonbury, CT 06033
Phone (860) 430-1762
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 |
|---|---|---|---|
| 002613 | CT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486512000000",
"number": "1528226537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 MAIN STREET",
"address_2": "CCSN",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "06033",
"telephone_number": "860-430-1762",
"fax_number": "860-430-2648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 MAIN STREET",
"address_2": "CCSN",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "06033",
"telephone_number": "860-430-1762",
"fax_number": "860-430-2648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWMAN",
"first_name": "TINA",
"middle_name": "MICHELLE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-27",
"last_updated": "2017-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CT",
"license": "002613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.