Individual provider Active NPI

Terry Boyd Eicher, PHD

  • Clinical Psychologist
  • New Haven, CT
National Provider Identifier
1952406464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
001769 Issued in CT
Practice address
291 Whitney Avenue
Suite 104
New Haven, CT 06511
Phone
(203) 772-4066
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 001769 CT Primary

Addresses

Primary practice location

291 Whitney Avenue
Suite 104
New Haven, CT 06511

Mailing address

96 Linden Street
New Haven, CT 06511
Phone (203) 772-4066

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
I20061216000028 CT Practitioner - Clinical Psychologist 2365441532 Practice locations: New Haven, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Yale University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

291 Whitney Ave
Suite 104
New Haven, CT 06511-3700
Phone (203) 772-4066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001769CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Psychiatric Group PC Past Accepting new patients
Spectrum Psychiatric Group PC Past Accepting new patients

Organizations & group practices 2

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952406464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 LINDEN STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-772-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 WHITNEY AVENUE",
            "address_2": "SUITE 104",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-772-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHER",
        "first_name": "TERRY",
        "middle_name": "BOYD",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.