Individual provider Active NPI

John A Healy, PH.D.

  • Cognitive & Behavioral Psychologist
  • Brookfield, CT
National Provider Identifier
1851444574
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
001305 Issued in CT
Practice address
60 Old New Milford Rd
Brookfield, CT 06804-2430
Phone
(203) 740-9659
Fax
(203) 248-1513
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 001305 CT Primary

Addresses

Primary practice location

60 Old New Milford Rd
Brookfield, CT 06804-2430

Mailing address

PO Box 185417
Hamden, CT 06518-0417
Phone (203) 740-9659

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
I20110519000158 CT Practitioner - Clinical Psychologist 5294911657 Practice locations: East Lyme, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15 Chesterfield Rd
Suite 218
East Lyme, CT 06333-1730
Phone (860) 287-2641

35 S Edgewood Rd
Niantic, CT 06357-2030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Chiropractic, LLC PastSince Nov 16, 2017 Accepting new patients

Organizations & group practices 1

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1851444574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185417",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065180417",
            "telephone_number": "203-740-9659",
            "fax_number": "203-248-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 OLD NEW MILFORD RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042430",
            "telephone_number": "203-740-9659",
            "fax_number": "203-248-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEALY",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CT",
            "license": "001305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.