Individual provider Active NPI

Charles W. Zanor, PH.D.

  • Clinical Psychologist
  • West Springfield, MA
National Provider Identifier
1649343435
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 2319 PR Issued in MA
Practice address
1111 Elm St
West Springfield, MA 01089-1540
Phone
(413) 736-8158
Fax
(413) 736-0140
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 2319 PR MA Primary

Addresses

Primary practice location

1111 Elm St
West Springfield, MA 01089-1540

Mailing address

1111 Elm St
West Springfield, MA 01089-1540
Phone (413) 736-8158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131211000151 CT Practitioner - Clinical Psychologist 2062605579 Practice locations: Suffield, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

75 Diane LN
Suffield, CT 06078-2626

880 Burbank Ave
Suffield, CT 06078-1459
Phone (860) 748-2102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2319MAMDBehavioral Analyst
PY 2319 PRMAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649343435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 ELM ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891540",
            "telephone_number": "413-736-8158",
            "fax_number": "413-736-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 ELM ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891540",
            "telephone_number": "413-736-8158",
            "fax_number": "413-736-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANOR",
        "first_name": "CHARLES",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PY 2319 PR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

Verify at the official NPI Registry.