NPIMap

Organization Active NPI

CT Psychological Associates

Doing business as Connecticut Neuropsychological Associates, LLC

  • Clinical Psychologist
  • Norwich, CT
National Provider Identifier
1790199784
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
003313 Issued in CT
Legal business name
CT PSYCHOLOGICAL ASSOCIATES
Doing business as
Connecticut Neuropsychological Associates, LLC
Practice address
12 Case St
Suite 301
Norwich, CT 06360-2222
Phone
(860) 889-7274
Fax
(860) 889-2131
NPI assigned
Jun 17, 2014
Last updated
Jun 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Authorized official

Name
Dr. Caleb Peck, PSY.DNPI 1750699070
Title
Manager/Neuropsychologist
Phone
(860) 889-7274

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 003313 CT
Psychologist 103T00000X 003313 CT
Psychologist 103T00000X 003357 CT
Adult Development & Aging Psychologist 103TA0700X 003313 CT
Cognitive & Behavioral Psychologist 103TB0200X 003313 CT
Clinical Psychologist 103TC0700X 003357 CT
Clinical Psychologist 103TC0700X 003313 CT Primary
Counseling Psychologist 103TC1900X 003357 CT
Clinical Child & Adolescent Psychologist 103TC2200X 003313 CT
Family Psychologist 103TF0000X 003357 CT
Forensic Psychologist 103TF0200X 003313 CT
Psychoanalysis Psychologist 103TP0814X 003357 CT
Group Psychotherapy Psychologist 103TP2701X 003357 CT
Rehabilitation Psychologist 103TR0400X 003313 CO

Addresses

Primary practice location

12 Case St
Suite 301
Norwich, CT 06360-2222

Mailing address

12 Case St
Suite 301
Norwich, CT 06360-2222
Phone (860) 889-7274

Other names 1

  • Connecticut Neuropsychological Associates, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

12 Case St
Ste 301
Norwich, CT 06360
Phone (860) 889-7274

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1790199784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CASE ST",
            "address_2": "SUITE 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "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": "12 CASE ST",
            "address_2": "SUITE 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "telephone_number": "860-889-7274",
            "fax_number": "860-889-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT PSYCHOLOGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "CALEB",
        "authorized_official_title_or_position": "MANAGER/NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "860-889-7274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "003313",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003313",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003357",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CT",
            "license": "003313",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CT",
            "license": "003313",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003357",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003313",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CT",
            "license": "003357",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": "003313",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CT",
            "license": "003357",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CT",
            "license": "003313",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "CT",
            "license": "003357",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CT",
            "license": "003357",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "CO",
            "license": "003313",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connecticut Neuropsychological Associates, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.