Amanda Poling-Tierney, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3902 Issued in CT

Practice address

575 Main St FL 2
Middletown, CT 06457-2845

Phone

(860) 347-6971

Fax

(860) 638-2099

NPI assigned

Jun 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.polingtierney@chcict.eclinicaldirectplus.com

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.

• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Middletown, CT
  • NPI 1952591851
  Medicare reassignment NPD
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1003332446
  NPD

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1801412960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 MAIN ST FL 2",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572845",
            "telephone_number": "860-347-6971",
            "fax_number": "860-638-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 MAIN ST FL 2",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572845",
            "telephone_number": "860-347-6971",
            "fax_number": "860-638-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLING-TIERNEY",
        "first_name": "AMANDA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole B Pleines, LCSW
• Nila Plocha, CRNA
• Priscila Giana Podesta
• Donald B Polansky, MSW LCSW
• Christina Marie Polce-Erfe, CDAC
• Chelsea Poloski, LCSW
• Mirlene Polycarpe, FNP, DNP
• Jennifer Carta Pons
• Positive Solutions Therapy, LLC
• Marc N Potenza, MD PHD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.