Daniel R Brockett PHD LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

001851 Issued in CT

Legal business name

DANIEL R BROCKETT PHD LLC

Practice address

2 Pomperaug Office Park
Suite 206D
Southbury, CT 06488-2288

Phone

(203) 264-3050

Fax

(203) 264-2426

NPI assigned

Apr 19, 2012

Last updated

Sep 17, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel R. Brockett, PH.D.NPI 1801921333

Title

Owner

Phone

(203) 264-3050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Raymond Brockett, PH.D.

  • Psychologist
  • Southbury, CT
  • NPI 1801921333
  Medicare reassignment NPD Authorized official
• Nancy Millian, PSYD

  • Psychologist
  • Southbury, CT
  • NPI 1578556882
  NPD (past)

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1932466547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 206D",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882288",
            "telephone_number": "203-264-3050",
            "fax_number": "203-264-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 206D",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882288",
            "telephone_number": "203-264-3050",
            "fax_number": "203-264-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL R BROCKETT PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "BROCKETT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-264-3050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "001851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yanike Curry, LADC
• Ariana Marie Cusack, M.S., BCBA
• James Cusmano
• Mary Daly, SLP
• Debbie Lyn Remigio Damoyan, PT
• Kaveh Shahmohammadi Davoudi, MD
• Rebecca Dawn, MA, LPC
• Joseph De Beauvoir, M.D.
• Michael De Luca, PT
• Gregory Gerard Decandia, MD

• Clinical Neuropsychologist in Southbury, CT
• Providers in Southbury, CT by specialty
• Clinical Neuropsychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.