Individual provider Active NPI

Lisa A. Kuntz, ED.D.

  • Psychologist
  • West Hartford, CT
National Provider Identifier
1760598106
Registry record updated Dec 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2079 Issued in CT
Practice address
784 Farmington Ave
West Hartford, CT 06119-1619
Phone
(860) 523-4450
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2079 CT Primary

Addresses

Primary practice location

784 Farmington Ave
West Hartford, CT 06119-1619

Mailing address

PO Box 1027
Windsor, CT 06095-6127
Phone (860) 683-1047

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
002079CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Center for Psychotherapy,LLC PastSince Jun 13, 2013 Accepting new patients
Clementine Counseling PastSince May 7, 2023 Accepting new patients

Organizations & group practices 2

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260576000000",
    "number": "1760598106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060956127",
            "telephone_number": "860-683-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 FARMINGTON AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191619",
            "telephone_number": "860-523-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNTZ",
        "first_name": "LISA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "2079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2009; 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.