JP Behavioral Health LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002878 Issued in CT

Legal business name

JP BEHAVIORAL HEALTH LLC

Practice address

45 S Main St
Suite 70
West Hartford, CT 06107-2441

Phone

(516) 205-6080

NPI assigned

Jun 14, 2016

Organization subpart

No

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

Authorized official

Name

Purvi Shah Vanderploeg, PH.D

Title

C0-Owner- Clinical Psychologist

Phone

(516) 205-6080

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1871943514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 PENN DR",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191041",
            "telephone_number": "516-205-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S MAIN ST",
            "address_2": "SUITE 70",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072441",
            "telephone_number": "516-205-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JP BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "VANDERPLOEG",
        "authorized_official_first_name": "PURVI",
        "authorized_official_middle_name": "SHAH",
        "authorized_official_title_or_position": "C0-OWNER- CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "516-205-6080",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.