Individual provider Active NPI

Christina Vasiliki Kiss, PSYD

  • Clinical Psychologist
  • Farmington, CT
National Provider Identifier
1841667177
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3906 Issued in CT
Practice address
231 Farmington Ave
Farmington, CT 06032-1940
Phone
(203) 272-6007
NPI assigned
Aug 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 023555 NY
Clinical Psychologist 103TC0700X 3906 CT Primary

Addresses

Primary practice location

231 Farmington Ave
Farmington, CT 06032-1940

Mailing address

231 Farmington Ave
Farmington, CT 06032-1940
Phone (203) 272-6007

Other practice location 1

15 Mountain Estates Dr
Avon, CT 06001-2105
Phone (516) 297-7331

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
I20230629001677 CT Practitioner - Clinical Psychologist 8325407919 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3906CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Telepsych PLLC CurrentSince Jan 1, 2024 Accepting new patients
Northeast Neuropsychology, LLC CurrentSince May 22, 2023 Accepting new patients

Locations

609 W Johnson Ave
Ste 104
Cheshire, CT 06410
Phone (203) 272-6007

Organizations & group practices 2

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": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1841667177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321940",
            "telephone_number": "203-272-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321940",
            "telephone_number": "203-272-6007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Mountain Estates Dr",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "CT",
            "postal_code": "060012105",
            "country_code": "US",
            "telephone_number": "516-297-7331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISS",
        "first_name": "CHRISTINA",
        "middle_name": "VASILIKI",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "023555",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "3906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.