Active NPI
Faith Anne Dohm, PH.D.
- Clinical Psychologist
- Middletown, CT
National Provider Identifier
1881726339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001614
- Practice address
- 163 College St
Middletown, CT 06457-3238 - Phone
- (860) 346-0906
- NPI assigned
- Mar 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001614 | CT | Primary |
Addresses
Primary practice location
163 College St
Middletown, CT 06457-3238
Mailing address
168R Tri Mountain Rd
Durham, CT 06422-2310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001614 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881726339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168R TRI MOUNTAIN RD",
"city": "DURHAM",
"state": "CT",
"postal_code": "064222310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 COLLEGE ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573238",
"telephone_number": "860-346-0906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOHM",
"first_name": "FAITH",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.