Active NPI
Pamela Fadakar, PSYD
- Psychologist
- West Hartford, CT
National Provider Identifier
1609909696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 002764
- Practice address
- 1007 Farmington Avenue
Suite 5
West Hartford, CT 06107 - Phone
- (860) 586-8167
- Fax
- (860) 586-8192
- NPI assigned
- Mar 13, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 002764 | CT | Primary |
Addresses
Primary practice location
1007 Farmington Avenue
Suite 5
West Hartford, CT 06107
Mailing address
8 Keystone Circle
Avon, CT 06001
Phone (860) 677-0817
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002764 | CT | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609909696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 KEYSTONE CIRCLE",
"city": "AVON",
"state": "CT",
"postal_code": "06001",
"telephone_number": "860-677-0817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 FARMINGTON AVENUE",
"address_2": "SUITE 5",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "06107",
"telephone_number": "860-586-8167",
"fax_number": "860-586-8192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADAKAR",
"first_name": "PAMELA",
"name_prefix": "Mrs.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "002764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, 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.