Individual provider Active NPI

Geraldine M Lenz, PHD

  • Clinical Psychologist
  • West Hartford, CT
National Provider Identifier
1891879920
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
000824 Issued in CT
Practice address
836 Farmington Ave Ste 217B
West Hartford, CT 06119-1545
Phone
(860) 522-0665
Fax
(860) 278-8338
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0063481 NY
Clinical Psychologist 103TC0700X 2419 MA
Clinical Psychologist 103TC0700X 000824 CT Primary

Addresses

Primary practice location

836 Farmington Ave Ste 217B
West Hartford, CT 06119-1545

Mailing address

836 Farmington Ave Ste 217B
West Hartford, CT 06119-1545
Phone (860) 522-0665

Other identifiers 4

IdentifierTypeStateIssuer
P611725OtherCTOXFORD
006645OtherCTVALUE OPTIONS
0004230714OtherCTAETNA
060000824CT01OtherCTANTHEM

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
I20111220000899 CT Practitioner - Clinical Psychologist 2163566068 Practice locations: West Hartford, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18 N Main St
3Rd FL
West Hartford, CT 06107-1970
Phone (860) 522-0665

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000824CTMDAddiction (Substance Use Disorder) Counselor
0063481NYMDClinical Psychologist
2419MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Physicians PLLC PastSince May 9, 2021 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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1891879920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 FARMINGTON AVE STE 217B",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191545",
            "telephone_number": "860-522-0665",
            "fax_number": "860-278-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 FARMINGTON AVE STE 217B",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191545",
            "telephone_number": "860-522-0665",
            "fax_number": "860-278-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENZ",
        "first_name": "GERALDINE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0063481",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2419",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "000824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P611725",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "006645",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004230714",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "060000824CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.