Active NPI
Minnah Wahida Farook, PHD
- Psychologist
- New Haven, CT
National Provider Identifier
1801262134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 004057
- Practice address
- 675 Townsend Ave Unit 121
New Haven, CT 06512-3175 - Phone
- (586) 484-5696
- NPI assigned
- Aug 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 004057 | CT | Primary |
Addresses
Primary practice location
675 Townsend Ave Unit 121
New Haven, CT 06512-3175
Mailing address
675 Townsend Ave Unit 121
New Haven, CT 06512-3175
Phone (586) 484-5696
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004057 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756425600000",
"number": "1801262134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "675 TOWNSEND AVE UNIT 121",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065123175",
"telephone_number": "586-484-5696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 TOWNSEND AVE UNIT 121",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065123175",
"telephone_number": "586-484-5696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAROOK",
"first_name": "MINNAH",
"middle_name": "WAHIDA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-20",
"last_updated": "2025-08-29",
"certification_date": "2025-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "004057",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790731081",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.