Kristina Hallett, PHD, Abpp. Inc.
Organization Active NPI Clinical Psychologist · Suffield, CT
NPI 1720511389 · NPPES record last updated Apr 10, 2024
Key facts
- NPI
- 1720511389
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 002493 (CT)
- Legal business name
- KRISTINA HALLETT, PHD, ABPP. INC.
- Practice address
- 880 Burbank Ave
Suffield, CT 06078-1459 - Phone
- (860) 965-1655
- Fax
- (860) 668-4943
- NPI assigned
- Apr 10, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Kristina Hallett, PHD, ABPP
- Title
- Owner
- Phone
- (860) 965-1655
Practitioners 2
-
Kristina Marie Hallett, PH.D., ABPP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170525001823 | CT | Part B Supplier - Clinic/Group Practice | 6608143441 |
Receives reassigned benefits from 1 practitioner Practice locations: Suffield, CT |
National Provider Directory
Locations
880 Burbank Ave
Suffield, CT 06078
Phone (860) 965-1655
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 002493 | CT | Yes |
Addresses
Primary practice location
880 Burbank Ave
Suffield, CT 06078-1459
Mailing address
880 Burbank Ave
Suffield, CT 06078-1459
Phone (860) 965-1655
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008066110 | Medicaid | CT | |
| W50652 | Medicaid | MA |
Other providers in Suffield, CT
- Kelly Kenney
- Elise Christine Kight
- Eileen C Kirschbaum
- Ronald D Kirschbaum
- Aleksandr Kozlov
- Barbara Lafrance
- Adrian Laureano
- Donald R Ledoux
- Merrilee Leonhardt
- Joanne M Lertora
All providers in Suffield, CT · Clinical Psychologist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.