Active NPI
James Joseph Cassidy, PHD
- Clinical Psychologist
- Middletown, CT
National Provider Identifier
1679823116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001886
- Practice address
- 151 Broad St
Middletown, CT 06457-3327 - Phone
- (860) 342-0760
- Fax
- (860) 346-0054
- NPI assigned
- Sep 12, 2012
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Clinical Psychologist | 103TC0700X | 001886 | CT | Primary |
| Counseling Psychologist | 103TC1900X | |||
| Forensic Psychologist | 103TF0200X | 001886 | CT | |
| Group Psychotherapy Psychologist | 103TP2701X |
Addresses
Primary practice location
151 Broad St
Middletown, CT 06457-3327
Mailing address
151 Broad St
Middletown, CT 06457-3327
Phone (860) 342-0760
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
- Credentials
- Juris Doctor, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001886 | CT | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347408000000",
"number": "1679823116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 BROAD ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573327",
"telephone_number": "860-342-0760",
"fax_number": "860-346-0054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 BROAD ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573327",
"telephone_number": "860-342-0760",
"fax_number": "860-346-0054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSIDY",
"first_name": "JAMES",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-12",
"last_updated": "2012-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001886",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CT",
"license": "001886",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.