Connecticut Psychological Associates, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

003346 Issued in CT

Legal business name

CONNECTICUT PSYCHOLOGICAL ASSOCIATES, LLC

Practice address

4 Forest Park Drive
Farmington, CT 06032-1443

Phone

(860) 235-3395

Fax

(888) 504-2375

NPI assigned

Oct 31, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Christine L. Gillies, PSY.D.

Title

President

Phone

(860) 235-3395

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1689079774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FLORENCE WAY",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060323443",
            "telephone_number": "860-235-3395",
            "fax_number": "888-504-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FOREST PARK DRIVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321443",
            "telephone_number": "860-235-3395",
            "fax_number": "888-504-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT PSYCHOLOGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "GILLIES",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-235-3395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003346",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "CT",
            "license": "003346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Farmington, CT
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.