Individual provider Active NPI

Douglas I Zlatin, PH.D.

  • Clinical Psychologist
  • Norwich, CT
National Provider Identifier
1841399094
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
00688 Issued in CT
Practice address
12 Case St
Suite 301
Norwich, CT 06360-2222
Phone
(860) 889-7274
Fax
(860) 889-2131
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 00688 CT Primary

Addresses

Primary practice location

12 Case St
Suite 301
Norwich, CT 06360-2222

Mailing address

12 Case St
Suite 301
Norwich, CT 06360-2222
Phone (860) 889-7274

Other identifiers 1

IdentifierTypeStateIssuer
060000688CT01OtherCTBLUE CROSS

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
00688CTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841399094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CASE ST",
            "address_2": "SUITE 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "telephone_number": "860-889-7274",
            "fax_number": "860-889-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CASE ST",
            "address_2": "SUITE 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "telephone_number": "860-889-7274",
            "fax_number": "860-889-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZLATIN",
        "first_name": "DOUGLAS",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "00688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "060000688CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.