Avon Simsbury Psychotherapy, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1811 Issued in CT

Legal business name

AVON SIMSBURY PSYCHOTHERAPY, LLC

Practice address

111 Simsbury Rd
Avon, CT 06001-3763

Phone

(860) 989-7687

NPI assigned

Mar 6, 2014

Last updated

Mar 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sarah J Gamble, PH.D.NPI 1588606768

Title

Owner

Phone

(860) 989-7687

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Simsbury Psychotherapy, LLC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sarah Jean Gamble, PH.D.

  • Clinical Psychologist
  • Simsbury, CT
  • NPI 1588606768
  NPD (past) Authorized official

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1558787176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SIMSBURY RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013763",
            "telephone_number": "860-989-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SIMSBURY RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013763",
            "telephone_number": "860-989-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON SIMSBURY PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-989-7687",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "1811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IDENTIFICATION NUMBER",
            "identifier": "680001804",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simsbury Psychotherapy, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Psychologist in Avon, CT
• Providers in Avon, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.

Verify at the official NPI Registry.