Lisa Oransoff, PHD

Individual provider Active NPI Clinical Psychologist · Pomfret Center, CT

NPI 1629048988 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1629048988
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
001505 (CT)
Practice address
161 Mashamnquet Rd
Pomfret Center, CT 06259
Phone
(860) 928-5904
Fax
(860) 928-0634
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 Dog LN
B
Storrs, CT 06268-2225
Phone (860) 306-4341

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20071108000511 CT Practitioner - Clinical Psychologist 7810085842 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1505CTMDOccupational Therapy Assistant
001505CTMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Oransoff PHD LLC Clinical Current
since Sep 1, 2005
Accepting new patients

Locations

18 Dog Ln
Ste B
Storrs Mansfield, CT 06268
Phone (860) 337-3300

18 Dog Ln
#B
Storrs Mansfield, CT 06268
Phone (860) 306-4341

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 001505 CT Yes

Addresses

Primary practice location

161 Mashamnquet Rd
Pomfret Center, CT 06259

Mailing address

PO Box 191
Pomfret Center, CT 06259-0191
Phone (860) 928-5904

Other identifiers

IdentifierTypeStateIssuer
255027OtherCTMANAGED HEALTH NETWORK
060001505CT01OtherCTBLUE CROSS

Other providers in Pomfret Center, CT

All providers in Pomfret Center, CT · Clinical Psychologist in Connecticut

Sources for this page

Verify at the official NPI Registry.