Kathleen Mildred Humpage, RN, NCBTMB

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

R19817 Issued in CT

Practice address

138 Wood Pond Rd
Glastonbury, CT 06033-3702

Phone

(860) 508-4245

Fax

(860) 659-2559

NPI assigned

Oct 30, 2019

Last updated

Oct 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1811531171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 WOOD POND RD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060333702",
            "telephone_number": "860-508-4245",
            "fax_number": "860-659-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 WOOD POND RD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060333702",
            "telephone_number": "860-508-4245",
            "fax_number": "860-659-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPAGE",
        "first_name": "KATHLEEN",
        "middle_name": "MILDRED",
        "credential": "RN, NCBTMB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CT",
            "license": "R19817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven M Horowitz, M.D.
• Sherri Huang, MA, CCC-SLP, RMT
• Traci Jo Hubbard, ATC
• Thomas Terrence Huck, MSW
• Sabrina Hudson, CCC-SLP
• Kaitlin Maria Iacomini, LCSW
• Ian R Cameron MD PC
• Awais Ibad, M.D
• Hiba Ibad
• Immerse LLC

• Psychiatric/Mental Health Registered Nurse in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Psychiatric/Mental Health Registered Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.