Carlene Davidson, PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

300 Hebron Ave Ste 217
Glastonbury, CT 06033-2192

Phone

(860) 659-2697

NPI assigned

Nov 6, 2015

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

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1831562255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BLOOMFIELD AVE",
            "address_2": "300 HEBRON AVE. SUITE 217",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171545",
            "telephone_number": "860-768-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEBRON AVE STE 217",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332192",
            "telephone_number": "860-659-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "CARLENE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan C Danberg, OD
• Courtney Michelle Danieluk, BCBA-LBA
• John M Dasilva, M.D.
• Peter Dasilva, MS OTR/L
• Alison David
• Doreen Sullivan Davis, IBCLC
• Mary Davis, LCSW, RD
• Gary William Dayton, PSY.D.
• Anna-Christina Decker, OTR/L
• Alexandra Defrance, PA-C

• Clinical Child & Adolescent Psychologist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Clinical Child & Adolescent Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.