Mark Jacob Kirschner, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

001705 Issued in CT

Practice address

3018 Dixwell Ave
Hamden, CT 06518

Phone

(203) 288-3554

Fax

(203) 281-0235

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Ohio Medical University, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Behavioral Health Consultants, LLCGroup PAC ID 9032018411, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Behavioral Health Consultants, LLC

  • Psychologist
  • Hamden, CT
  • NPI 1447269410
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740291327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3018 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06518",
            "telephone_number": "203-288-3554",
            "fax_number": "203-281-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 DIXWELL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06518",
            "telephone_number": "203-288-3554",
            "fax_number": "203-281-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHNER",
        "first_name": "MARK",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "001705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rakeema King
• Rae Lynne Poirrier Kinler, MD
• Sara Kinsel
• Ryan James Kirby
• Jane Kircaldie, PT
• Justin Klein, PHARM D
• Samatha C Kleiner
• Jennifer Kleis
• Jessica Klouda, LCSW
• Lisa M Koczak, DPT

• Psychologist in Hamden, CT
• Providers in Hamden, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.