Caleb Paul Peck, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

003313 Issued in CT

Practice address

150 Otrobando Ave
Norwich, CT 06360-2116

Phone

(860) 889-7274

Fax

(860) 889-2131

NPI assigned

Sep 21, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Neuropsychological Associates LLCGroup PAC ID 9638494446, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecticut Neuropsychological Associates, LLC

  dba Clarus Health Alliance

  • Clinical Psychologist
  • Norwich, CT
  • NPI 1497151245

  Clinical Neuropsychologist

  Medicare reassignment Care Compare group NPD Authorized official
• CT Psychological Associates

  dba Connecticut Neuropsychological Associates, LLC

  • Clinical Psychologist
  • Norwich, CT
  • NPI 1790199784
  Authorized official Same address or phone
• Eastern Connecticut Rehabili

  • Physical Therapy Clinic/Center
  • Gales Ferry, CT
  • NPI 1700895729
  NPD (past)

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1750699070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 OTROBANDO AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602116",
            "telephone_number": "860-889-7274",
            "fax_number": "860-889-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 OTROBANDO AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602116",
            "telephone_number": "860-889-7274",
            "fax_number": "860-889-2131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Retreat Avenue",
            "address_2": "Hartford Hospital Psychiatry Dept",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063310",
            "country_code": "US",
            "telephone_number": "860-545-7940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "CALEB",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-21",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003313",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "KS",
            "license": "1364",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "003313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008033136",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Paul, APRN
• Nigel Paul
• Resham Singh Pawar, M.D.
• Renee Pawluk, DPT
• Mark Anthony Peake
• Julie Michele Peck, MBBCHB
• Elizabeth Nicole Peckham, NP-C
• Samuel Eli Peckham, APRN
• Pediatric Services of America, LLC (Aveanna Healthcare)
• Andrea Pedraza-Jennings, LCSW

• Clinical Neuropsychologist in Norwich, CT
• Providers in Norwich, CT by specialty
• Clinical Neuropsychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.