Psychological Associates LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PSYCHOLOGICAL ASSOCIATES LLC

Practice address

2157 North Ave
Bridgeport, CT 06604-2438

Phone

(203) 335-0345

NPI assigned

May 28, 2010

Organization subpart

No

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

Authorized official

Name

Robert Matefy, PH.D.NPI 1225173131

Title

Owner

Phone

(203) 335-0345

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Emil Matefy, PH.D.

  • Clinical Psychologist
  • Bridgeport, CT
  • NPI 1225173131
  Medicare reassignment NPD Authorized official
• Kirk Denys Matefy, LCSW

  • Clinical Social Worker
  • Bridgeport, CT
  • NPI 1649879602
  Medicare reassignment NPD
• Jennifer Ann Gullesserian Straley, PH.D.

  • Psychologist
  • White Plains, NY
  • NPI 1992986566
  NPD (past)

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409443200000",
    "number": "1770802886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2157 NORTH AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 NORTH AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042438",
            "telephone_number": "203-335-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-28",
        "last_updated": "2014-08-31",
        "status": "A",
        "authorized_official_last_name": "MATEFY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-335-0345",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.