Jennie Song, Psy.D., LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

JENNIE SONG, PSY.D., LLC

Practice address

270 Farmington Ave Ste 313
Farmington, CT 06032-1909

Phone

(860) 333-8421

NPI assigned

Feb 13, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jennie Song, PSYDNPI 1427496108

Title

Clinical Psychologist

Phone

(860) 333-8421

Specialties & licenses 1

Addresses

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.

• Jennie Song, PSY.D.

  • Clinical Psychologist
  • Farmington, CT
  • NPI 1427496108
  NPD Authorized official

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701475200000",
    "number": "1578260139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BRINLEY WAY",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061111152",
            "telephone_number": "860-878-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 FARMINGTON AVE STE 313",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321909",
            "telephone_number": "860-333-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIE SONG, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-12-02",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "860-333-8421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Homan Javaheri, D.M.D.
• Marian Alinet Javier Saldana, M.D
• Mark William Jay, LCSW
• Fabienne Jean, DO
• Wayne D. Jenkins, OD
• Jennifer J Stagg ND LLC
• Tiara Jennings, MD
• Haley Jensen, MD
• Candice G Jersey, D.O
• Julia Jesmond, SLP

• Clinical Psychologist in Farmington, CT
• Providers in Farmington, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; 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.