Active NPI
Steven Mogel, PHD CLINICAL PSYCHOL
- Clinical Psychologist
- Watertown, CT
National Provider Identifier
1609095652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- CT000319
- Practice address
- 380 Main St
Watertown, CT 06795 - Phone
- (860) 274-6069
- NPI assigned
- Apr 25, 2007
- Sex
- Male
- 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 Psychologist | 103TC0700X | CT000319 | CT | Primary |
Addresses
Primary practice location
380 Main St
Watertown, CT 06795
Mailing address
66 Lovelace Dr
West Hartford, CT 06117
Phone (860) 232-1962
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060000319CT02 | Other | CT | ANTHEM BCBS |
| 211983 | Other | MHN |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CT000319 | CT | MD | Clinical Psychologist |
| 000319 | CT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Town and Country Pediatrics and Family Medicine, P.C. | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CIDIBD
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Watertown, CT
- NPI 1942414081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609095652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 LOVELACE DR",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "06117",
"telephone_number": "860-232-1962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 MAIN ST",
"city": "WATERTOWN",
"state": "CT",
"postal_code": "06795",
"telephone_number": "860-274-6069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGEL",
"first_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "PHD CLINICAL PSYCHOL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "CT000319",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "060000319CT02",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "211983",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, 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.