NPIMap

Organization Active NPI

JCP Psychological Services P.C.

  • Clinical Psychologist
  • Milford, CT
National Provider Identifier
1679973994
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3411 Issued in CT
Legal business name
JCP PSYCHOLOGICAL SERVICES P.C.
Practice address
7 Deerfield Ave
Milford, CT 06460-7317
Phone
(203) 850-0140
NPI assigned
Aug 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Authorized official

Name
Dr. Joanna C. Procaccini, PSY.D.
Title
President
Phone
(203) 850-0140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 3411 CT Primary

Addresses

Primary practice location

7 Deerfield Ave
Milford, CT 06460-7317

Mailing address

PO Box 750834
Forest Hills, NY 11375-0834
Phone (718) 268-6600

Other identifiers 1

IdentifierTypeStateIssuer
3411OtherCTCT DPH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1679973994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 750834",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113750834",
            "telephone_number": "718-268-6600",
            "fax_number": "718-268-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 DEERFIELD AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064607317",
            "telephone_number": "203-850-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCP PSYCHOLOGICAL SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-25",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "PROCACCINI",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-850-0140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "3411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT DPH",
            "identifier": "3411",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.