NPIMap

Organization Active NPI

Hartford Psychological Services LLC.

  • Clinical Psychologist
  • Hartford, CT
National Provider Identifier
1649493115
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
001877 Issued in CT
Legal business name
HARTFORD PSYCHOLOGICAL SERVICES LLC.
Practice address
191 Franklin Ave
Suite Number 3
Hartford, CT 06114-1386
Phone
(860) 296-0094
Fax
(860) 296-7125
NPI assigned
Apr 11, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Rafael Mora de Jesus, PH.D.NPI 1366503906
Title
Director
Phone
(860) 296-0094

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 001877 CT Primary

Addresses

Primary practice location

191 Franklin Ave
Suite Number 3
Hartford, CT 06114-1386

Mailing address

191 Franklin Ave
Suite Number 3
Hartford, CT 06114-1386
Phone (860) 296-0094

National Provider Directory

National Provider Directory
Tax ID family
Hartford Psychological Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649493115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 FRANKLIN AVE",
            "address_2": "SUITE NUMBER 3",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061141386",
            "telephone_number": "860-296-0094",
            "fax_number": "860-296-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 FRANKLIN AVE",
            "address_2": "SUITE NUMBER 3",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061141386",
            "telephone_number": "860-296-0094",
            "fax_number": "860-296-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTFORD PSYCHOLOGICAL SERVICES LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORA DE JESUS",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "860-296-0094",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.