Individual provider Active NPI

Ann S Lenz, PSY.D

  • Clinical Psychologist
  • Hartford, CT
National Provider Identifier
1700060217
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
002645 Issued in CT
Practice address
675 Tower Ave
Suite 301
Hartford, CT 06112-1260
Phone
(860) 714-2750
Fax
(860) 714-8591
NPI assigned
Dec 19, 2007
Last updated
Dec 19, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 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 002645 CT Primary

Addresses

Primary practice location

675 Tower Ave
Suite 301
Hartford, CT 06112-1260

Mailing address

675 Tower Ave
Suite 301
Hartford, CT 06112-1260
Phone (860) 714-2750

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidCT

Other names 1

  • Ann S Bushaw Former name

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

State licenses

LicenseStateTypeSpecialty
002645CTMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1700060217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "SUITE 301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121260",
            "telephone_number": "860-714-2750",
            "fax_number": "860-714-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "SUITE 301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121260",
            "telephone_number": "860-714-2750",
            "fax_number": "860-714-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENZ",
        "first_name": "ANN",
        "middle_name": "S",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "BUSHAW",
            "middle_name": "S",
            "credential": "PSY.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 19, 2007; 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.