Active NPI
Timothy Crowley, PSYD
- Clinical Psychologist
- Avon, CT
National Provider Identifier
1639125461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2102
- Practice address
- 21 Waterville Rd
Avon, CT 06001-2097 - Phone
- (860) 674-2691
- Fax
- (860) 677-6443
- NPI assigned
- May 25, 2006
- Last updated
- Nov 21, 2017
- 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 | 2102 | CT | Primary |
Addresses
Primary practice location
21 Waterville Rd
Avon, CT 06001-2097
Mailing address
21 Waterville Rd
Avon, CT 06001-2097
Phone (860) 674-2691
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2102 | CT | MD | Physical Therapy Assistant |
| 002102 | CT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medoptions Behavioral Health Assoc, LLC | Clinical | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511222400000",
"number": "1639125461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 WATERVILLE RD",
"city": "AVON",
"state": "CT",
"postal_code": "060012097",
"telephone_number": "860-674-2691",
"fax_number": "860-677-6443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 WATERVILLE RD",
"city": "AVON",
"state": "CT",
"postal_code": "060012097",
"telephone_number": "860-674-2691",
"fax_number": "860-677-6443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROWLEY",
"first_name": "TIMOTHY",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2017-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "2102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.