Michelle Marie Haudegand-Gough, OT/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

001925 Issued in CT

Practice address

160 Simsbury Rd
West Hartford, CT 06117-1469

Phone

(860) 523-3808

NPI assigned

Mar 2, 2022

Last updated

Mar 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1871240515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 FOSTER ST",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742936",
            "telephone_number": "860-812-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 SIMSBURY RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171469",
            "telephone_number": "860-523-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUDEGAND-GOUGH",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "OT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "001925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hartford Family Medicine Center, LLC
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• Hartford Healthcare Medical Group, Inc
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• Dana Ashley Harvey, LMSW
• Jacqueline Foster Haughton, COTA/L
• Kaylee Renee Havanick, LPC-A
• Haven Health Center of West Hartford, LLC
• Terri Haven, MSW
• Traci Hazelton, PT, ATC, CSCS

• Occupational Therapist in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.