Active NPI
Michael W Watson, PSYD
- Clinical Child & Adolescent Psychologist
- Plainville, CT
National Provider Identifier
1578600300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Practice address
- 91 Northwest Dr
Plainville, CT 06062-1534 - Phone
- (860) 793-3500
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
91 Northwest Dr
Plainville, CT 06062-1534
Mailing address
182 Mark Dr
Coventry, CT 06238-1168
Phone (860) 742-9693
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578600300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "182 MARK DR",
"city": "COVENTRY",
"state": "CT",
"postal_code": "062381168",
"telephone_number": "860-742-9693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 NORTHWEST DR",
"city": "PLAINVILLE",
"state": "CT",
"postal_code": "060621534",
"telephone_number": "860-793-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "MICHAEL",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.