Individual provider Active NPI

Marci B. Korwin, PHD

  • Clinical Psychologist
  • West Hartford, CT
National Provider Identifier
1760415475
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
001586 Issued in CT
Practice address
345 N Main St
Suite 302
West Hartford, CT 06117-2515
Phone
(860) 233-9772
Fax
(860) 236-9402
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 001586 CT Primary

Addresses

Primary practice location

345 N Main St
Suite 302
West Hartford, CT 06117-2515

Mailing address

345 N Main St
Suite 302
West Hartford, CT 06117-2515
Phone (860) 233-9772

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110621000510 CT Practitioner - Clinical Psychologist 0042107237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological Health Associates LLCGroup PAC ID 9638066822, 11 clinicians

Practice addresses (Care Compare)

701 Cottage Grove Rd
Suite C210
Bloomfield, CT 06002-4207
Phone (860) 233-9772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1586CTMDClinical Social Worker
001586CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Health Associates LLC Clinical CurrentSince Jan 22, 1991 Accepting new patients

Locations

701 Cottage Grove Rd
Ste C210
Bloomfield, CT 06002
Phone (860) 233-9772

345 N Main St
Ste 302
West Hartfrd, CT 06117
Phone (860) 233-9772

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760415475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST",
            "address_2": "SUITE 302",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172515",
            "telephone_number": "860-233-9772",
            "fax_number": "860-236-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST",
            "address_2": "SUITE 302",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172515",
            "telephone_number": "860-233-9772",
            "fax_number": "860-236-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORWIN",
        "first_name": "MARCI",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.