Individual provider Active NPI

Charisse Delvecchio, PSYD

  • Psychologist
  • Stamford, CT
National Provider Identifier
1801413810
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4814 Issued in CT
Practice address
103 W Broad St
Stamford, CT 06902-3713
Phone
(203) 324-6127
NPI assigned
Jun 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4814 CT Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

103 W Broad St
Stamford, CT 06902-3713

Mailing address

1650 Westfield St
West Springfield, MA 01089-2023
Phone (203) 317-0088

Other practice location 1

1695 Main St Fl 400
Springfield, MA 01103-1063
Phone (413) 739-5572

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241107000511 CT Practitioner - Clinical Psychologist 8224562798 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Services Institute, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Community Health Center Inc Current Accepting new patients
Community Health Center Inc CurrentSince Aug 15, 2024 Accepting new patients

Locations

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

1695 Main St
Fl 400
Springfield, MA 01103
Phone (413) 739-5572

Interoperability endpoints

  • Direct secure messaging: charisse.delvecchio@chcict.eclinicaldirectplus.com

Organizations & group practices 3

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": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1801413810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 WESTFIELD ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010892023",
            "telephone_number": "203-317-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W BROAD ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023713",
            "telephone_number": "203-324-6127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 Main St Fl 400",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011031063",
            "country_code": "US",
            "telephone_number": "413-739-5572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELVECCHIO",
        "first_name": "CHARISSE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "4814",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.