Individual provider Active NPI

Hope Ellen Rollner, PH.D.

  • Clinical Psychologist
  • Glastonbury, CT
National Provider Identifier
1871126672
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
002092 Issued in CT
Practice address
300 Hebron Ave Ste 217
Glastonbury, CT 06033-2192
Phone
(860) 690-2365
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 002092 CT Primary

Addresses

Primary practice location

300 Hebron Ave Ste 217
Glastonbury, CT 06033-2192

Mailing address

134 Kinne Rd
Glastonbury, CT 06033-3816
Phone (860) 690-2365

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
I20231209000036 CT Practitioner - Clinical Psychologist 7416306923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Psychological Health and Development Associates LLCGroup PAC ID 6103129333, 6 clinicians

Practice addresses (Care Compare)

185 Silas Deane Hwy
Wethersfield, CT 06109-1219
Phone (860) 338-5911

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2092CTMDOptometrist
002092CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Health & Development Associates, LLC Multi-Specialty CurrentSince Nov 1, 2023 Accepting new patients

Locations

185 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 296-1700

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1871126672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 KINNE RD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060333816",
            "telephone_number": "860-690-2365"
        },
        {
            "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": "860-690-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLNER",
        "first_name": "HOPE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.